Individual provider · Type 1 NPI
Lorraine Gwen Grube, PA-C
Medical Physician Assistant · Cripple Creek, CO
NPI number
1184614828
Active
Practice location
412 North C Street
Cripple Creek, CO 80813
Mailing address
3205 N Academy Blvd, Suite 130
Colorado Springs, CO 80917-5101
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1516 (CO) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
About NPI 1184614828
Lorraine Gwen Grube, PA-C's National Provider Identifier is 1184614828, issued on Oct 25, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Cripple Creek, CO. The record was last updated on Dec 8, 2014.