Provider Demographics
NPI:1558545160
Name:GROFF, JENNIFER MAGUIRE (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MAGUIRE
Last Name:GROFF
Suffix:
Gender:F
Credentials:FNP
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 22389
Mailing Address - Street 2:PMB 82739
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202
Mailing Address - Country:US
Mailing Address - Phone:866-315-2626
Mailing Address - Fax:
Practice Address - Street 1:2948 CARTER HILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2531
Practice Address - Country:US
Practice Address - Phone:334-694-2262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143033363L00000X
MA215926364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health