Individual
JUSTIN GROCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
115 WINWOOD DR, SUITE 105, LEBANON, TN 37087-1340
(615) 444-4126
(855) 785-2890
Mailing address
115 WINWOOD DR, SUITE 105, LEBANON, TN 37087-1340
(615) 444-4126
(855) 785-2890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
20598
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3306523
UNITED HEALTHCARE
TN
01
—
6060213
BCBS OF TN
TN
01
—
620842749
HUMANA
TN
01
—
P01697499
R/R MEDICARE
TN
05
—
Q021233
—
TN
Enumeration date
09/21/2015
Last updated
02/13/2017
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