Grove, Shannon R
Grove, Shannon R is an individual health care provider with primary practice located at 10 Centennial Dr Ste 104 , Peabody MA 01960-2298. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Grove, Shannon R can be contacted via phone (978) 535-1110.Contact Information
Primary practice address
10 Centennial Dr Ste 104
Peabody MA 01960-2298
Phone: (978) 535-1110
Fax: (978) 535-2907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | RN2299385 | Massachusetts |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 2299385 | Massachusetts |
Profile Details
| NPI number | 1396292892 |
|---|---|
| LBN Legal business name | Grove, Shannon R |
| Credentials | PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2016 |
| Last updated | Jun 22nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396292892 | NPPES |
| Massachusetts | MEDICAID | 020860 |
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