Provider Demographics
NPI:1689259830
Name:GRUBBS, BIRGIT ERIKA (NP)
Entity Type:Individual
Prefix:
First Name:BIRGIT
Middle Name:ERIKA
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 NACOGDOCHES ST STE 280
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-2444
Mailing Address - Country:US
Mailing Address - Phone:903-541-5380
Mailing Address - Fax:
Practice Address - Street 1:203 NACOGDOCHES ST STE 280
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2444
Practice Address - Country:US
Practice Address - Phone:903-541-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1124261363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily