MEDICARE: ANITA L GROESCHKE CNP

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
1	363L00000X	Nurse Practitioner	NP-03609	OH

General Provider Information

NPI Number	:	1881675049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA L GROESCHKE CNP

Provider Business Mailing Address
First Line	:	9345 SUSSEX DR
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2613
Country	:	US
Telephone Number	:	440-503-4209
Fax Number	:	440-888-0523

Provider Business Practice Location Address
First Line	:	9345 SUSSEX DR
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2613
Country	:	US
Telephone Number	:	440-503-4209
Fax Number	:	440-888-0523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/03/2016

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