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Individual

JACQUELINE GROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN FNP-C

Contact information

Practice address
18697 BAGLEY RD, MIDDLEBURG HEIGHTS, OH 44130-3497
(440) 816-5600
Mailing address
240 MONTVIEW DR, MEDINA, OH 44256-2912
(330) 321-9849

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
397399
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0029732
OH

Other

Enumeration date
09/22/2015
Last updated
09/10/2021
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