Individual
MS. SHANNON R GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
10 CENTENNIAL DR STE 104, PEABODY, MA 01960-2298
(978) 535-1110
(978) 535-2907
Mailing address
10 CENTENNIAL DR STE 104, PEABODY, MA 01960-2298
(978) 535-1110
(978) 535-2907
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2299385
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2299385
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020860
—
MA
Enumeration date
09/01/2016
Last updated
06/22/2021
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