Provider Demographics
NPI:1902615503
Name:GRUETER, TAYLOR ANN ROSE (MHS, PA (ASCP))
Entity type:Individual
Prefix:
First Name:TAYLOR ANN
Middle Name:ROSE
Last Name:GRUETER
Suffix:
Gender:F
Credentials:MHS, PA (ASCP)
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4301 N STAR WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9262
Mailing Address - Country:US
Mailing Address - Phone:209-577-1200
Mailing Address - Fax:
Practice Address - Street 1:4301 N STAR WAY
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9262
Practice Address - Country:US
Practice Address - Phone:209-577-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory