Amy Grubbs, NP-C, PLLC
Organization Active NPI Nurse Practitioner · Hattiesburg, MS
NPI 1124494109 · NPPES record last updated Aug 13, 2015
Key facts
- NPI
- 1124494109
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R860597 (MS)
- Legal business name
- AMY GRUBBS, NP-C, PLLC
- Practice address
- 1420 S 28TH Ave
Hattiesburg, MS 39402-3107 - Phone
- (601) 705-0078
- NPI assigned
- Aug 13, 2015
- Organization subpart
- No
Authorized official
- Name
- Amy L Grubbs, NP-C
- Title
- Certified Nurse Practitioner
- Phone
- (601) 705-0078
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | R860597 | MS | Yes |
Addresses
Primary practice location
1420 S 28TH Ave
Hattiesburg, MS 39402-3107
Mailing address
1420 S 28TH Ave
Hattiesburg, MS 39402-3107
Phone (601) 705-0078
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.