Individual
LISA MARIE GRUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
687 W MAIN ST, HYANNIS, MA 02601-3421
(087) 718-1145
Mailing address
242 RAYNOR AVE, WHITMAN, MA 02382-2152
(617) 688-0803
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN2294514
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN2294514
MA
Other
Enumeration date
01/28/2018
Last updated
01/28/2019
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