Provider Demographics
NPI:1881942613
Name:GRUBBS, SYLVIA M (RN)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:M
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6918 GALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-7702
Mailing Address - Country:US
Mailing Address - Phone:937-760-6096
Mailing Address - Fax:937-235-6754
Practice Address - Street 1:6918 GALVIN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-7702
Practice Address - Country:US
Practice Address - Phone:937-760-6096
Practice Address - Fax:937-235-6754
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH228096163W00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8121535956Medicaid
OH2081205Medicaid