Provider Demographics
NPI:1043426828
Name:GROVE, LYNN ANN (CRNA, CRNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:GROVE
Suffix:
Gender:F
Credentials:CRNA, CRNP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:ANN
Other - Last Name:GEIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:1020 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:JERSEY SHORE
Practice Address - State:PA
Practice Address - Zip Code:17740-1729
Practice Address - Country:US
Practice Address - Phone:570-398-5131
Practice Address - Fax:570-398-3195
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN332556L367500000X
PASP012332363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA291616F6KMedicare PIN
PA50117027OtherCAPITAL BLUE CROSS
PA1020204170001Medicaid
PA117061Medicare PIN
PAP00451154Medicare PIN