MEDICARE: JULIA DAWN HACKETT GROVE 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
1	163W00000X	Registered Nurse	90842	OK
2	367500000X	Certified Registered Nurse Anesthetist	AP117357	TX
3	367500000X	Certified Registered Nurse Anesthetist	EL31275	NH
4	163W00000X	Registered Nurse	687284	TX
5	367500000X	Certified Registered Nurse Anesthetist	0090842	OK
6	163W00000X	Registered Nurse	681712	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1215119219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA DAWN HACKETT GROVE CRNA

Provider Business Mailing Address
First Line	:	7951 SHOAL CREEK BLVD STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-7582
Country	:	US
Telephone Number	:	512-584-8404
Fax Number	:	737-377-0442

Provider Business Practice Location Address
First Line	:	8015 SHOAL CREEK BLVD STE 103
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-8051
Country	:	US
Telephone Number	:	512-467-7246
Fax Number	:	512-467-7247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/24/2025

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