Provider Demographics
NPI:1255703054
Name:GRUBB, JULIANE (DNP APN FNP-BC)
Entity type:Individual
Prefix:DR
First Name:JULIANE
Middle Name:
Last Name:GRUBB
Suffix:
Gender:F
Credentials:DNP APN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 YOUNG AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3133
Mailing Address - Country:US
Mailing Address - Phone:856-291-8920
Mailing Address - Fax:
Practice Address - Street 1:401 YOUNG AVE STE 320
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3133
Practice Address - Country:US
Practice Address - Phone:856-291-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16088700163WP0200X
NJ26NJ00844900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0650897Medicaid