Provider Demographics
NPI:1497312870
Name:GRUBBS, SHARECKA (RN)
Entity Type:Individual
Prefix:
First Name:SHARECKA
Middle Name:
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 GRIFFIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2329
Mailing Address - Country:US
Mailing Address - Phone:214-434-3141
Mailing Address - Fax:
Practice Address - Street 1:621 GRIFFIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2329
Practice Address - Country:US
Practice Address - Phone:214-434-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX932852163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse