Individual
TAWNYA GROVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6546 E INGRAM ST, MESA, AZ 85205-3785
(480) 201-5143
Mailing address
6546 E INGRAM ST, MESA, AZ 85205-3785
(480) 201-5143
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
231477
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231477
AZ BOARD OF NURSING
AZ
Enumeration date
09/05/2019
Last updated
09/05/2019
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