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Individual
JORDAN ELAINE GRUBE
Active
Individual
JORDAN ELAINE GRUBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1257873
VA
163W00000X
Registered Nurse
688591
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
0024173423
VA
363LA2200X
Adult Health Nurse Practitioner
0024173423
VA
363LG0600X
Gerontology Nurse Practitioner
0024173423
VA
Other
Enumeration date
03/23/2015
Last updated
11/14/2024
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