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General NPI Number Information
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NPI Number | 1659429249
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Entity Type | Organization
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Legal Business Name | ASHLAND INTEGRATIVE CARE PC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 1745 ASHLAND ST
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City | ASHLAND
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State | OR
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Zip | 97520-2328
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Country | US
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Telephone | 541-201-3173
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Fax | 541-201-3173
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Provider Business Mailing Address
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Address Line | PO BOX 1300
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City | ASHLAND
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State | OR
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Zip | 97520-0058
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Country | US
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Telephone | 541-201-3173
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Fax | 561-427-1393
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JOANN ELLEN GRUBER
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Credential | NP
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Telephone | 541-201-3173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201050217
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 201050218
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License Number State | OR
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