Grube, Justin Paul

Grube, Justin Paul is an individual health care provider with primary practice located at 411 Stageline Rd Ste 150 , Hudson WI 54016-7848. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Grube, Justin Paul can be contacted via phone (715) 531-6700.

Contact Information

Primary practice address
411 Stageline Rd Ste 150 Hudson WI 54016-7848
Phone: (715) 531-6700
Fax: (715) 531-6701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 544 Wyoming
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 14748 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 544 Wyoming
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7515 Wisconsin

Profile Details

NPI number 1811217417
LBN Legal business name Grube, Justin Paul
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2010
Last updated Jan 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811217417 NPPES
Wyoming MEDICAID 142617600

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