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General NPI Number Information
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NPI Number | 1396552733
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Entity Type | Individual
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Provider Name | SARA EMILY GRUNSKY MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 827 SPRING ST
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City | MEDFORD
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State | OR
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Zip | 97504-6104
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Country | US
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Telephone | 541-732-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 508 WESTMINSTER DR
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City | EAGLE POINT
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State | OR
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Zip | 97524-9437
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Country | US
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Telephone | 412-277-1623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10034042
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License Number State | OR
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