Healthcare Provider Details

I. General information

NPI: 1376496547
Provider Name (Legal Business Name): MOUNTAIN VALLEY HEALTH & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N COALTER ST STE 301
STAUNTON VA
24401-2566
US

IV. Provider business mailing address

1600 N COALTER ST STE 301
STAUNTON VA
24401-2566
US

V. Phone/Fax

Practice location:
  • Phone: 540-324-3836
  • Fax: 502-237-9908
Mailing address:
  • Phone: 540-324-3836
  • Fax: 502-237-9908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE L GROFF
Title or Position: OWNER
Credential: FNP
Phone: 540-324-3836