Provider Demographics
NPI:1952803165
Name:GROHMAN, HEATHER RAYE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RAYE
Last Name:GROHMAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
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 1482
Mailing Address - Street 2:
Mailing Address - City:LA VERNIA
Mailing Address - State:TX
Mailing Address - Zip Code:78121-1422
Mailing Address - Country:US
Mailing Address - Phone:830-581-8027
Mailing Address - Fax:830-244-0833
Practice Address - Street 1:101 WOODBRIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-0109
Practice Address - Country:US
Practice Address - Phone:830-581-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX782085163W00000X
TXAP136825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse