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NPI Code Detail

MEDICARE: JOHN L. GROENEVELD ARNP

MEDICARE: JOHN L. GROENEVELD ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerA107375IA

General Provider Information

NPI Number : 1508255134
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN L. GROENEVELD ARNP
Provider Business Mailing Address
First Line : 1601 NW 114TH ST
Second Line : STE 347
City : DES MOINES
State : IA
Zip : 50325-7046
Country : US
Telephone Number : 515-224-1777
Fax Number : 515-225-6750
Provider Business Practice Location Address
First Line : 1601 NW 114TH ST
Second Line : STE 347
City : DES MOINES
State : IA
Zip : 50325-7046
Country : US
Telephone Number : 515-224-1777
Fax Number : 515-225-6750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2015
Last Update Date : 01/26/2015

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Directions to “ JOHN L. GROENEVELD ARNP” Practice Location

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