Organization
NICOLE GROVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE MARIE GROVE FNP-L (OWNER)
(937) 573-7452
Entity
Organization
Contact information
Practice address
1664 LONGBOW LANE, UNIT E, WEST CARROLLTON, OH 45449
(937) 301-6463
(855) 953-3569
Mailing address
1664 LONGBOW LANE, UNIT E, WEST CARROLLTON, OH 45449
(937) 301-6463
(855) 953-3569
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105016
—
OH
Enumeration date
04/30/2014
Last updated
08/07/2025
Update your record
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