Provider Demographics
NPI:1750847414
Name:GROTE, KATHERINE E (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:E
Last Name:GROTE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 GREEN HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-4632
Mailing Address - Country:US
Mailing Address - Phone:443-534-4793
Mailing Address - Fax:443-557-3238
Practice Address - Street 1:1209 GREEN HOLLY DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-4632
Practice Address - Country:US
Practice Address - Phone:443-534-4793
Practice Address - Fax:443-557-3238
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily