Individual
ANTIONETTE GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
540 MADISON OAK DR STE 310, SAN ANTONIO, TX 78258-3921
(210) 657-2100
Mailing address
540 MADISON OAK DR STE 310, SAN ANTONIO, TX 78258-3921
(210) 657-2100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1179901
TX
363LA2100X
Acute Care Nurse Practitioner
1179901
TX
363LG0600X
Gerontology Nurse Practitioner
1179901
TX
Other
Enumeration date
11/13/2024
Last updated
02/19/2025
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