Provider Demographics
NPI:1073301651
Name:GRIMES-WOOLBRIGHT, DENYSE M
Entity type:Individual
Prefix:
First Name:DENYSE
Middle Name:M
Last Name:GRIMES-WOOLBRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 O ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NE
Mailing Address - Zip Code:69336-4049
Mailing Address - Country:US
Mailing Address - Phone:308-241-2214
Mailing Address - Fax:
Practice Address - Street 1:1114 O ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NE
Practice Address - Zip Code:69336-4049
Practice Address - Country:US
Practice Address - Phone:308-241-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion