Provider Demographics
NPI:1023320264
Name:GRUSLIN, JENNIFER L (DONA TRAINED DOULA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:GRUSLIN
Suffix:
Gender:F
Credentials:DONA TRAINED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 ARNOLDS NECK DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7300
Mailing Address - Country:US
Mailing Address - Phone:401-921-4165
Mailing Address - Fax:
Practice Address - Street 1:253 ARNOLDS NECK DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7300
Practice Address - Country:US
Practice Address - Phone:401-921-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
27-2972914OtherEIN