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NPI Code Detail

MEDICARE: NATALIE M GROSE

MEDICARE: NATALIE M GROSE
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 Assistant
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1568133197
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE M GROSE
Provider Business Mailing Address
First Line : 1090 ARNOLD DR
Second Line :
City : LITTLE ROCK AFB
State : AR
Zip : 72099-4933
Country : US
Telephone Number : 501-987-7446
Fax Number :
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-539-9582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 03/28/2026

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Directions to “ NATALIE M GROSE ” Practice Location

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