# DR. JEANETTE BURGESS GRUBE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1437129954
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 13145 | HI | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 48394 | CO | Yes |

## Other

- **Enumeration date:** 01/26/2006
- **Last updated:** 06/02/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 021863 | KAISER COMMERCIAL NUMBER | CO |
| 05 | — | 41835875 | — | CO |