Individual
BRIDGET C. GROVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2610 N WOODLAWN BLVD, WICHITA, KS 67220-2729
(316) 858-2610
(316) 858-2793
Mailing address
2610 N WOODLAWN BLVD, WICHITA, KS 67220-2729
(316) 858-2610
(316) 858-2793
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15-00926
KS
363A00000X
Physician Assistant
Primary
15-00926
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200252120F
—
KS
05
—
200252120G
—
KS
Enumeration date
06/11/2007
Last updated
12/17/2010
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