Healthcare Provider Details

I. General information

NPI: 1336628031
Provider Name (Legal Business Name): KATHY GROVE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 S HARTMANN DR
LEBANON TN
37090-4064
US

IV. Provider business mailing address

PO BOX 306556
NASHVILLE TN
37230-6556
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-0200
  • Fax:
Mailing address:
  • Phone: 615-329-2294
  • Fax: 615-695-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number24485
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: