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Contact Information

LORA L GRUTKOWSKI, RN FNP-BC ACNS-BC
5883 VINE HILL ROAD
SEBASTOPOL, CA95472
 Phone: 707-824-8200
 Fax: 707-823-5800
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Clinical Nurse Specialist

364S00000X 89 Certified Clinical Nurse Specialist
 

Registered Nurse

163W00000X
 

Registered Nurse First Assistant

163WR0006X
Indicates primary specialty

NPI Profile & details for LORA L GRUTKOWSKI · (Female)

NPI # 1134280464
Status Active
Credentials RN FNP-BC ACNS-BC
Entity Individual
Enumeration date 12/12/2006
Last updated 09/24/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # CNS #1381
  • CA License # NP #18178
  • CA License # RN #365475
  • CA Medicaid CNS013810
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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