Individual
SUSAN K GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 S CARRIER PKWY, GRAND PRAIRIE, TX 75051-3702
(972) 262-5272
(972) 262-1921
Mailing address
1801 S CARRIER PKWY, GRAND PRAIRIE, TX 75051-3702
(972) 262-5272
(972) 262-1921
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP107780
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
456712YLPS
WMG MEDICARE
—
Enumeration date
09/30/2015
Last updated
12/03/2015
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