Gary Grover ACNP

NPI 1083623441 - Nurse Practitioner - 363LA2100X

NPI Details
NPI 1083623441
Gender Male
Enumeration Date 08/05/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
6025 WALNUT GROVE RD
SUITE 508
MEMPHIS TN, 38120-2131, US
Phone (901) 767-5864
Fax (901) 767-6591
Business Location
1500 W POPLAR AVE
SUITE 312
COLLIERVILLE TN, 38017-0601, US
Phone (901) 850-1170
Fax (901) 850-1169
Toxanomy
Taxonomy Code 363LA2100X
License State Tennessee
License Number 6785
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According to our database, Gary Grover ACNP NPI is 1083623441, taxonomy code is 363LA2100X and license number is 6785, license state is located at Tennessee. Gary Grover ACNP physically located at 6025 Walnut Grove Rd, Memphis TN, 38120-2131. NPI Number Gary Grover ACNP has the Individual type.

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1083623441 NPI number is provided on an as is basis without warranty of any kind. 1083623441 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Grover ACNP are for informational purposes only.