Provider Demographics
NPI:1386725836
Name:GROVE, ANNE LYNN (CNM)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:LYNN
Last Name:GROVE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:216 YOUNGS RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:KABGAYI SCHOOL OF NURSING
Practice Address - Street 2:
Practice Address - City:KABGAYI
Practice Address - State:SOUTHERN PROVINCE
Practice Address - Zip Code:BP 66
Practice Address - Country:RW
Practice Address - Phone:25078-945-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209005698367A00000X
OH08299-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D0432608OtherCLIA#
OH2755273OtherMEDICAID
ILMG1378985OtherDEA NUMBER