Provider Demographics
NPI:1356693204
Name:GROVES, KRISTIN MARIE (RN, BSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARIE
Last Name:GROVES
Suffix:
Gender:F
Credentials:RN, BSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SMITH RD STE 3004
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-5461
Mailing Address - Country:US
Mailing Address - Phone:432-699-6000
Mailing Address - Fax:432-699-6012
Practice Address - Street 1:15 SMITH RD STE 3004
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-5461
Practice Address - Country:US
Practice Address - Phone:432-699-6000
Practice Address - Fax:432-699-6012
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily