Individual provider · Type 1 NPI
Glenn M. Grushko, PNP
Pediatric Nurse Practitioner · Phoenix, AZ
NPI number
1023995164
Active
Practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | TEMP329979 (AZ) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1023995164
Glenn M. Grushko, PNP's National Provider Identifier is 1023995164, issued on Aug 20, 2025. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 1, 2025.