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NPI Code Detail

MEDICARE: LINDA M GROVER CRNA

MEDICARE: LINDA M GROVER CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist162884OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053312140
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA M GROVER CRNA
Provider Business Mailing Address
First Line : 369 COUNTY ROAD 108
Second Line :
City : FREMONT
State : OH
Zip : 43420-9732
Country : US
Telephone Number : 419-334-7115
Fax Number : 419-334-7115
Provider Business Practice Location Address
First Line : 2801 BAY PARK DR
Second Line :
City : OREGON
State : OH
Zip : 43616-4920
Country : US
Telephone Number : 419-690-7900
Fax Number : 419-697-7726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 11/03/2023

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