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NPI Code Detail

MEDICARE: PATRICIA J GROVE RN

MEDICARE: PATRICIA J GROVE RN
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 AnesthetistAA083165ME

General Provider Information

NPI Number : 1073599718
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA J GROVE RN
Provider Business Mailing Address
First Line : 300 MAIN ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7027
Country : US
Telephone Number : 207-795-0111
Fax Number :
Provider Business Practice Location Address
First Line : 300 MAIN ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7027
Country : US
Telephone Number : 207-795-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 03/26/2014

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