Provider Demographics
NPI:1730849183
Name:GRUBBS, JENNIFER MEYERING (NBC-HWC, MFS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MEYERING
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:NBC-HWC, MFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ELLSWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7228
Mailing Address - Country:US
Mailing Address - Phone:904-540-3236
Mailing Address - Fax:
Practice Address - Street 1:108 ELLSWORTH CIR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-7228
Practice Address - Country:US
Practice Address - Phone:904-540-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3087058