Provider Demographics
NPI:1306251970
Name:GROGG, CORRIE ELIZABETH (WHNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:CORRIE
Middle Name:ELIZABETH
Last Name:GROGG
Suffix:
Gender:F
Credentials:WHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 WV HIGHWAY 5 E
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26351-7602
Mailing Address - Country:US
Mailing Address - Phone:304-462-7322
Mailing Address - Fax:304-462-3418
Practice Address - Street 1:376 WV HIGHWAY 5 E
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:WV
Practice Address - Zip Code:26351-7602
Practice Address - Country:US
Practice Address - Phone:304-462-7322
Practice Address - Fax:304-462-8000
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV104933363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0125774Medicaid
OHH303420Medicare PIN