Provider Demographics
NPI:1891803813
Name:GROTHE, ANN M (RD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:GROTHE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:SUWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 SILVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-6052
Mailing Address - Country:US
Mailing Address - Phone:254-698-1681
Mailing Address - Fax:
Practice Address - Street 1:726 S FORT HOOD ST
Practice Address - Street 2:STE. # 115 - FMCNA CKD SERVICES
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-7431
Practice Address - Country:US
Practice Address - Phone:254-554-3366
Practice Address - Fax:254-628-8998
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06800133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal