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General NPI Number Information
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NPI Number | 1851701700
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Entity Type | Organization
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Legal Business Name | NICOLE GROVE LLC
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1664 LONGBOW LANE UNIT E
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City | WEST CARROLLTON
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State | OH
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Zip | 45449
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Country | US
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Telephone | 937-301-6463
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Fax | 855-953-3569
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Provider Business Mailing Address
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Address Line | 1664 LONGBOW LANE UNIT E
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City | WEST CARROLLTON
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State | OH
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Zip | 45449
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Country | US
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Telephone | 937-301-6463
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Fax | 855-953-3569
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Authorized Official
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Title or Position | OWNER
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Name | MS. NICOLE MARIE GROVE
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Credential | FNP-L
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Telephone | 937-573-7452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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