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NPI Code Detail

MEDICARE: STEPHANIE GROVE FNP

MEDICARE: STEPHANIE GROVE 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
1363LF0000XFamily Nurse Practitioner209-001461IL
2363LW0102XWomen's Health Nurse PractitionerARNP9396058FL

General Provider Information

NPI Number : 1295980365
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GROVE FNP
Provider Business Mailing Address
First Line : 2310 60TH STREET CT W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-6609
Country : US
Telephone Number : 941-792-4993
Fax Number : 941-795-2905
Provider Business Practice Location Address
First Line : 2310 60TH STREET CT W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-6609
Country : US
Telephone Number : 941-792-4993
Fax Number : 941-795-2905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2008
Last Update Date : 07/21/2022

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Directions to “ STEPHANIE GROVE FNP” Practice Location

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