| NPI | 1174242143 |
|---|---|
| Former Name | SHANNON GROE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0997776) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 0997776) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2026-01-22 |