Provider Demographics
NPI:1932695608
Name:GROFF, SUZANNE ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:ELIZABETH
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 1:31988 HACKMAN RD
Mailing Address - Street 2:
Mailing Address - City:BURR OAK
Mailing Address - State:MI
Mailing Address - Zip Code:49030-9658
Mailing Address - Country:US
Mailing Address - Phone:269-625-1189
Mailing Address - Fax:
Practice Address - Street 1:2000 GREEN RD STE 300
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1575
Practice Address - Country:US
Practice Address - Phone:734-995-3764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704297857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily