Pamela Sue Grover
Individual provider Active NPI Licensed Practical Nurse · Bloomville, OH
NPI 1275005779 · NPPES record last updated Dec 20, 2018
Key facts
- NPI
- 1275005779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN077670 (OH)
- Practice address
- 22 Clinton St
Bloomville, OH 44818-9399 - Phone
- (419) 983-4100
- NPI assigned
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN077670 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN077670 | OH | Yes |
Addresses
Primary practice location
22 Clinton St
Bloomville, OH 44818-9399
Mailing address
143 Schonhardt St
Tiffin, OH 44883-3028
Phone (567) 230-7864
Other providers in Bloomville, OH
- Shane Leslie Dentinger
- Bridget Dillinger
- Jennifer Leabell Ernsberger
- Karin Genette Fraelich
- Jocelyn Gower
- Hillstone Healthcare of Bloomville LLC
- Teresa Jo Huth
- Independent Living Solutions
- Mark Harrison Lambert
- Rodney Jay Lynch
All providers in Bloomville, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.