1508674912 NPI number — YVONNE BETH GREBE NURSE PRACTITIONER

Table of content: YVONNE BETH GREBE NURSE PRACTITIONER (NPI 1508674912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508674912 NPI number — YVONNE BETH GREBE NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREBE
Provider First Name:
YVONNE
Provider Middle Name:
BETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREBE
Provider Other First Name:
YVONNE
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NURSE PRACTITIONER
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1508674912
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
369 INDIAN LANE
Provider Second Line Business Mailing Address:
P. O. BOX 223
Provider Business Mailing Address City Name:
BOYERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19512-0223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-780-7496
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 INDIAN LANE
Provider Second Line Business Practice Location Address:
P. O. BOX 223
Provider Business Practice Location Address City Name:
BOYERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19512-0223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-780-7496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP031550 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com