Individual
JACQUELYN GRUER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4244 HAMILTON AVE, CINCINNATI, OH 45223-2048
(513) 681-4900
(513) 853-8432
Mailing address
4342 HAIGHT AVE, CINCINNATI, OH 45223-1749
(513) 542-8259
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN-187380/NM01412
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0629789
—
OH
01
—
109026341696
HUMANA
OH
01
—
201488810028
CARESOURCE
OH
Enumeration date
08/10/2005
Last updated
07/08/2007
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