Provider Demographics
NPI:1952994386
Name:GROVES, COURTNEY N (FNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:GROVES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19782 HIGHWAY 105 W STE 111
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-3104
Mailing Address - Country:US
Mailing Address - Phone:936-582-0229
Mailing Address - Fax:
Practice Address - Street 1:19782 HIGHWAY 105 W STE 111
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-3104
Practice Address - Country:US
Practice Address - Phone:936-582-0220
Practice Address - Fax:936-582-0222
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily