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General NPI Number Information
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NPI Number | 1710112933
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Entity Type | Individual
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Provider Name | MARY A GROVE ACNP, ANP, PHD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1003 ABBY RD
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-6500
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Country | US
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Telephone | 615-554-9047
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 ABBY RD
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-6500
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Country | US
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Telephone | 615-554-9047
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APN0000014367
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 3865
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | F432395-01
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APN0000014367
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3865
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F310865-01
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00879100
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License Number State | NJ
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