Healthcare Provider Details

I. General information

NPI: 1023568805
Provider Name (Legal Business Name): WENDY GRUBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S GEORGE ST SUITE 301
YORK PA
17401-1474
US

IV. Provider business mailing address

116 S GEORGE ST SUITE 301
YORK PA
17401-1474
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-8617
  • Fax: 717-854-6645
Mailing address:
  • Phone: 717-801-4821
  • Fax: 717-854-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016428
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: