Provider Demographics
NPI:1467761882
Name:GROVES ENTERPRISES PLLC
Entity Type:Organization
Organization Name:GROVES ENTERPRISES PLLC
Other - Org Name:YOURCARE YUKON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILICIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:405-350-4300
Mailing Address - Street 1:1029 E VANDAMENT AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4949
Mailing Address - Country:US
Mailing Address - Phone:405-350-4300
Mailing Address - Fax:405-350-4302
Practice Address - Street 1:1029 E VANDAMENT AVE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4949
Practice Address - Country:US
Practice Address - Phone:405-350-4300
Practice Address - Fax:405-350-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK208D00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty