Basic Information
| Provider Information | |||||||||
| NPI: | 1952803165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROHMAN | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | RAYE | ||||||||
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| Credential: | MSN, APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 499 10TH ST | ||||||||
| Address2: | |||||||||
| City: | FLORESVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781143175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8303931400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13857 US HIGHWAY 87 W | ||||||||
| Address2: | |||||||||
| City: | LA VERNIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781215919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8303931400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2018 | ||||||||
| LastUpdateDate: | 07/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 782085 | TX | N | Nursing Service Providers | Registered Nurse | 363LF0000X | AP136825 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.