Individual
MICHELE DIANE GRUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-4000
Mailing address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN589758
PA
Other
Enumeration date
11/05/2011
Last updated
03/29/2021
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