Kim Marie Grove PA-C

NPI 1770714263 - Physician Assistant - 363A00000X

NPI Details
NPI 1770714263
Gender Female
Enumeration Date 07/31/2009
Last Updated 01/04/2011
Entity Type Individual
Active Over 7 years ago
Practice Location
701 PARK AVE
HCMC MEDICINE CLINIC P7
MINNEAPOLIS MN, 55415-1623, US
Phone (612) 873-8707
Fax
Business Location
701 PARK AVE
HCMC DIRECT CARE P5
MINNEAPOLIS MN, 55415-1623, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Minnesota
License Number 10595
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According to our database, Kim Marie Grove PA-C NPI is 1770714263, taxonomy code is 363A00000X and license number is 10595, license state is located at Minnesota. Kim Marie Grove PA-C physically located at 701 Park Ave, Minneapolis MN, 55415-1623. NPI Number Kim Marie Grove PA-C has the Individual type.

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1770714263 NPI number is provided on an as is basis without warranty of any kind. 1770714263 is maintained by the National Plan & Provider Enumeration System. The contents of Kim Marie Grove PA-C are for informational purposes only.