Provider Demographics
NPI:1336833276
Name:CARBO-GRUVER, MARIA TERESA (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:TERESA
Last Name:CARBO-GRUVER
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 1:310 KLINE ST
Mailing Address - Street 2:
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1329
Mailing Address - Country:US
Mailing Address - Phone:267-374-5354
Mailing Address - Fax:
Practice Address - Street 1:838 PENN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1108
Practice Address - Country:US
Practice Address - Phone:610-988-4838
Practice Address - Fax:855-547-2441
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN740659163WG0000X
PASP027666363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice