MRS. LORA LEE GRUTKOWSKI (NPI# 1134280464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134280464 |
| Entity Type | Individual |
| Full Name | MRS. LORA LEE GRUTKOWSKI |
| Credential | RN FNP-BC ACNS-BC |
| Practice Address |
5883 Vine Hill Road Sebastopol CA 95472 |
| Practice Telephone | 7078248200 |
| Practice Fax Number | 7078235800 |
| Mailing Telephone | 7078248200 |
| Mailing Fax Number | 7078235800 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-09-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN #365475 | CA | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | NP #18178 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364S00000X | Clinical Nurse Specialist | CNS #1381 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 163WR0006X |
Registered Nurse Specialization: Registered Nurse First Assistant |
RN #365475 | CA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CNS013810 | 05 |
| Street Address |
5883 VINE HILL ROAD |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154612687 | Elaine Weil | Nurse Practitioner | 7064 Corline Ct Ste A, Sebastopol, CA 95472-4528 | 2011-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528817 | Gemekia Latrisha Morales | Nurse Practitioner | 1800 N. California, Stockton, CA 95952 | 2020-11-08 |
| 1447851324 | Anna Patricia Torres | Nurse Practitioner | 1158 Santa Lucia Dr, Pittsburg, CA 94565-7615 | 2020-11-05 |
| 1447851647 | Melanie Ganotisi | Nurse Practitioner | 11541 Blucher Ave Unit 125, Granada Hills, CA 91344-4362 | 2020-11-04 |
| 1659971729 | Raquel Y Mccarthy | Nurse Practitioner | 334 Via Vera Cruz Ste 257, San Marcos, CA 92078-2643 | 2020-10-28 |
| 1689274607 | Aleksandra Zaitseva | Nurse Practitioner | 6850 Sepulveda Blvd Ste 215, Van Nuys, CA 91405-4450 | 2020-10-28 |
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1861092355 | Vilma Estrada | Nurse Practitioner | 37945 28th St E, Palmdale, CA 93550-5521 | 2020-10-26 |
| 1871192492 | Folashade Jayeoba | Nurse Practitioner | 7453 Tucson Ln, Fontana, CA 92336-0712 | 2020-10-23 |
| 1467051391 | Careforyou LLC | Nurse Practitioner | 806 14th St, Modesto, CA 95354-1023 | 2020-10-21 |
| 1427657550 | Adriana Sarah Pettross | Nurse Practitioner | 35286 Vista De Todo, Capistrano Beach, CA 92624-1847 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.