Provider Demographics
NPI:1225660285
Name:GROTERS, ASHLEY A (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:GROTERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 N OTSEGO AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-2502
Mailing Address - Country:US
Mailing Address - Phone:989-732-3529
Mailing Address - Fax:989-732-7865
Practice Address - Street 1:652 N OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-2502
Practice Address - Country:US
Practice Address - Phone:989-732-3529
Practice Address - Fax:989-732-7865
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704271300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner