Individual provider · Type 1 NPI

Destiny Grove

Psychiatric/Mental Health Nurse Practitioner · Richmond, KY

NPI number 1053159749 Active

Practice location

1012 Center Dr
Richmond, KY 40475-3838

Mailing address

PO Box 267
Richmond, KY 40476-0267

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X4024428 (KY)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1053159749

Destiny Grove's National Provider Identifier is 1053159749, issued on Jul 17, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Richmond, KY. The record was last updated on Jul 17, 2024.