MEDICARE: LIZBETH CAROL GRUBBS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP136720	TX

General Provider Information

NPI Number	:	1568964203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZBETH CAROL GRUBBS FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 489
Second Line	:
City	:	MT ENTERPRISE
State	:	TX
Zip	:	75681-0489
Country	:	US
Telephone Number	:	903-822-3076
Fax Number	:	866-305-8303

Provider Business Practice Location Address
First Line	:	106 W RUSK ST
Second Line	:
City	:	MOUNT ENTERPRISE
State	:	TX
Zip	:	75681-7581
Country	:	US
Telephone Number	:	903-822-3076
Fax Number	:	877-305-8303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2018
Last Update Date	:	04/07/2025

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