Provider Demographics
NPI:1285771097
Name:GROVE, ASTRID MARIE (RM)
Entity type:Individual
Prefix:MRS
First Name:ASTRID
Middle Name:MARIE
Last Name:GROVE
Suffix:
Gender:F
Credentials:RM
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:MARIE
Other - Last Name:DILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM
Mailing Address - Street 1:PO BOX 773398
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477
Mailing Address - Country:US
Mailing Address - Phone:970-343-2968
Mailing Address - Fax:800-303-1851
Practice Address - Street 1:942 OAK ST.
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPINGS
Practice Address - State:CO
Practice Address - Zip Code:80487
Practice Address - Country:US
Practice Address - Phone:970-343-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 246175M00000X
VT107-0000036176B00000X
CO00000181176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay