Provider Demographics
NPI:1558545160
Name:GROFF, JENNIFER MAGUIRE (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MAGUIRE
Last Name:GROFF
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 GLYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5584
Mailing Address - Country:US
Mailing Address - Phone:334-568-5025
Mailing Address - Fax:334-568-5040
Practice Address - Street 1:1841 GLYNWOOD DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5584
Practice Address - Country:US
Practice Address - Phone:334-568-5025
Practice Address - Fax:334-568-5021
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215926364SF0001X
AL1-143033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health