Healthcare Provider Details

I. General information

NPI: 1851110365
Provider Name (Legal Business Name): HEIDI GRUMBRIDGE NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 ROUTE 31 STE 1000
FLEMINGTON NJ
08822-5752
US

IV. Provider business mailing address

215 STATE ROUTE 31 RM 116
FLEMINGTON NJ
08822-5752
US

V. Phone/Fax

Practice location:
  • Phone: 908-237-7018
  • Fax:
Mailing address:
  • Phone: 908-284-1125
  • Fax: 908-284-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15174900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: