Organization
AMY GRUBBS, NP-C, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L GRUBBS NP-C (CERTIFIED NURSE PRACTITIONER)
(601) 705-0078
Entity
Organization
Contact information
Practice address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 705-0078
Mailing address
1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
(601) 705-0078
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R860597
MS
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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