Provider Demographics
NPI:1639255037
Name:GRUBBS, JAMES CURTIS (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CURTIS
Last Name:GRUBBS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2358
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85547-2358
Mailing Address - Country:US
Mailing Address - Phone:928-472-2311
Mailing Address - Fax:928-472-9174
Practice Address - Street 1:220 S 63RD ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1619
Practice Address - Country:US
Practice Address - Phone:480-641-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN059709367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ5798OtherJCG HEALTHNET
AZ1639255037OtherNPI
AZAZ0164500OtherJG BLUE CROSS BLUE SHIELD
AZ1639255037OtherNPI
AZAZ5798OtherJCG HEALTHNET