Provider Demographics
NPI:1013060383
Name:GROVER, ANNE M (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:GROVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3768
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-3768
Mailing Address - Country:US
Mailing Address - Phone:209-723-3704
Mailing Address - Fax:209-723-0272
Practice Address - Street 1:220 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-6242
Practice Address - Country:US
Practice Address - Phone:209-723-3704
Practice Address - Fax:209-723-0272
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13926363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant