Provider Demographics
NPI:1063517092
Name:GROTE, DEBORAH ANN (FNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:GROTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5039 BECKWITH BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2293
Mailing Address - Country:US
Mailing Address - Phone:877-329-8081
Mailing Address - Fax:512-329-8281
Practice Address - Street 1:5039 BECKWITH BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2293
Practice Address - Country:US
Practice Address - Phone:877-329-8081
Practice Address - Fax:512-329-8281
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024968363LF0000X
TX449480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J0112Medicare UPIN