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General NPI Number Information
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NPI Number | 1376628636
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Entity Type | Individual
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Provider Name | EMMA JANE GROETHE CNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 9302 OLDE 8 RD
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City | NORTHFIELD
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State | OH
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Zip | 44067-2027
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Country | US
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Telephone | 330-468-1661
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Fax | 330-908-1145
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Provider Business Mailing Address
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Address Line | 485 CARLSFIELD WAY
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City | HUDSON
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State | OH
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Zip | 44236-1173
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Country | US
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Telephone | 216-288-4004
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Fax | 330-678-3501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 133665
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 09173
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License Number State | OH
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