Provider Demographics
NPI:1295030393
Name:GROVES, AMYE WILLIS (NP)
Entity Type:Individual
Prefix:
First Name:AMYE
Middle Name:WILLIS
Last Name:GROVES
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:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-0720
Mailing Address - Country:US
Mailing Address - Phone:256-840-5800
Mailing Address - Fax:256-840-5600
Practice Address - Street 1:122 N SNEAD ST
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-1763
Practice Address - Country:US
Practice Address - Phone:256-840-5800
Practice Address - Fax:256-840-5600
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-088716363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health