Provider Demographics
NPI:1841873593
Name:GROVE, ALEXUS JADEN (LPN)
Entity type:Individual
Prefix:
First Name:ALEXUS
Middle Name:JADEN
Last Name:GROVE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 KINGS CHARTER RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1941
Mailing Address - Country:US
Mailing Address - Phone:614-900-1874
Mailing Address - Fax:
Practice Address - Street 1:1380 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1025
Practice Address - Country:US
Practice Address - Phone:614-488-7117
Practice Address - Fax:614-488-7118
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.164264.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse