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Individual
JENNIFER G. GROVES
Active
Individual
JENNIFER G. GROVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005261
VA
363A00000X
Physician Assistant
10001825A
IN
363A00000X
Physician Assistant
10001825B
IN
363A00000X
Physician Assistant
99066589A
IN
363A00000X
Physician Assistant
Primary
PA15632
TX
363A00000X
Physician Assistant
PA901
KY
363A00000X
Physician Assistant
—
DC
363AM0700X
Medical Physician Assistant
PA901
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201162650
—
IN
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
95005351
—
KY
01
—
ASC1019
ASC MEDICARE
KY
01
—
CB5773
RR GROUP NO
KY
01
—
P00379405
RR MEDICARE PIN
KY
Enumeration date
10/05/2006
Last updated
08/18/2023
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