Provider Demographics
NPI:1861385189
Name:GROVER, CONNIE
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:GROVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9708 VAL VERDE DR
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-7042
Mailing Address - Country:US
Mailing Address - Phone:402-492-8414
Mailing Address - Fax:
Practice Address - Street 1:9708 VAL VERDE DR
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-7042
Practice Address - Country:US
Practice Address - Phone:402-492-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide