| NPI | 1427571017 |
|---|---|
| Former Name | STEPHANIE JEAN GROGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009765) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009765) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5009765) | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2023-11-27 |