| Michelle Grubb, CNM | |
|
96 E Kimballs Ln Ste 202, Draper, UT 84020-5021 | |
| (801) 523-3053 | |
| (801) 523-3059 |
| Full Name | Michelle Grubb |
|---|---|
| Gender | Female |
| Speciality | Advanced Practice Midwife |
| Location | 96 E Kimballs Ln Ste 202, Draper, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467708487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | 5948089-4402 (Utah) | Primary |
| Entity Name | St Mark's Gynecology Oncology Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053593921 PECOS PAC ID: 4486736279 Enrollment ID: O20080201000232 |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Grubb, CNM Po Box 198546, Atlanta, GA 30384-8546 Ph: () - | Michelle Grubb, CNM 96 E Kimballs Ln Ste 202, Draper, UT 84020-5021 Ph: (801) 523-3053 |
Veronica Carol Blair, CNM WHNP Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 96 E Kimballs Ln Ste 202, Draper, UT 84020 Phone: 801-523-3053 Fax: 801-523-3059 | |
Kimberly L Stuck, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 96 E Kimballs Ln Ste 202, Draper, UT 84020 Phone: 801-523-3053 Fax: 801-523-3059 | |
Nathan Matthew Morris, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 96 E Kimballs Ln Ste 202, Draper, UT 84020 Phone: 801-523-3053 Fax: 801-523-3059 |