Provider Demographics
NPI:1255420790
Name:GROFF, MARIAN ZANDER (CNM MSN)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:ZANDER
Last Name:GROFF
Suffix:
Gender:F
Credentials:CNM MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2724
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89803
Mailing Address - Country:US
Mailing Address - Phone:775-738-7877
Mailing Address - Fax:775-738-9542
Practice Address - Street 1:1995 ERRECART BLVD
Practice Address - Street 2:STE 202
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801
Practice Address - Country:US
Practice Address - Phone:775-738-7877
Practice Address - Fax:775-738-9542
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00164367A00000X
NVRN17972367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife