MEDICARE: MICHELE DAVIS GROETZINGER FNP

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	363LF0000X	Family Nurse Practitioner	723904	TX

General Provider Information

NPI Number	:	1255770970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE DAVIS GROETZINGER FNP

Provider Business Mailing Address
First Line	:	201 WESTLANE CIR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-3186
Country	:	US
Telephone Number	:	254-855-0829
Fax Number	:

Provider Business Practice Location Address
First Line	:	2675 S ABILENE ST STE 100
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2363
Country	:	US
Telephone Number	:	720-507-4779
Fax Number	:	833-941-5047

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

Provider Enumeration Date	:	06/15/2013
Last Update Date	:	08/20/2024

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