Provider Demographics
NPI:1679943591
Name:GRUBER, JESSICA (ND)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GRUBER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 HAMILTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2000
Mailing Address - Country:US
Mailing Address - Phone:513-214-1927
Mailing Address - Fax:
Practice Address - Street 1:6240 HAMILTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-2000
Practice Address - Country:US
Practice Address - Phone:513-214-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
VT099.0134040175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath