NPI | 1528453362 |
---|---|
Other Name | STACIA A GROVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024172491) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172491) |
Enumeration Date | 2015-03-30 |
Last Update Date | 2024-10-24 |