Provider Demographics
NPI:1497903801
Name:GRUBBS, BARBARA L (ACNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PALMETTO PARK BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7968
Mailing Address - Country:US
Mailing Address - Phone:803-520-5100
Mailing Address - Fax:803-520-5104
Practice Address - Street 1:108 PALMETTO PARK BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7968
Practice Address - Country:US
Practice Address - Phone:803-520-5100
Practice Address - Fax:803-520-5104
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3686363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care