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NPI Code Detail

MEDICARE: ANGELINE GROHS

MEDICARE: ANGELINE GROHS
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
1363A00000XPhysician Assistant193685AK

General Provider Information

NPI Number : 1407599970
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINE GROHS
Provider Business Mailing Address
First Line : 9220 LAKE OTIS PKWY STE 9
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4249
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9220 LAKE OTIS PKWY STE 9
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4249
Country : US
Telephone Number : 907-344-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2022
Last Update Date : 03/27/2023

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Directions to “ ANGELINE GROHS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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