Provider Demographics
NPI:1942290655
Name:GROFF, SHEILA KATHLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:KATHLEEN
Last Name:GROFF
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 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-426-2030
Mailing Address - Fax:866-926-3612
Practice Address - Street 1:3560 ROUTE 309
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-2001
Practice Address - Country:US
Practice Address - Phone:484-426-2030
Practice Address - Fax:866-926-3612
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018559363LF0000X
CT1657363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004199982Medicaid
CT004199982Medicaid