Individual
MRS. MARY ELLEN GROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
40 OKATIE CTR BLVD STE 100, BLUFFTON, SC 29909-7519
(843) 708-8888
(843) 705-7024
Mailing address
AGAPE SENIOR PRIMARY CARE INC, 1624 MAIN STREET, COLUMBIA, SC 29201-2818
(803) 726-2350
(803) 753-9102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3789
SC
363L00000X
Nurse Practitioner
R04165
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121922400
—
MD
05
—
NP1602
—
SC
Enumeration date
03/14/2006
Last updated
04/01/2019
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