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General NPI Number Information
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NPI Number | 1750142881
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Entity Type | Organization
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Legal Business Name | MERLEEN GROVER APRN, CNM LC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 200 W 5TH ST
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City | WINNEMUCCA
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State | NV
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Zip | 89445-3413
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Country | US
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Telephone | 775-304-4245
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Fax | 775-201-5000
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Provider Business Mailing Address
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Address Line | 6030 WATER CANYON RD
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City | WINNEMUCCA
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State | NV
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Zip | 89445-4160
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Country | US
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Telephone | 775-385-1410
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Fax | 775-201-5000
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Authorized Official
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Title or Position | CEO
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Name | MERLEEN LAVON GROVER
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Credential | APRN, CNM
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Telephone | 775-385-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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