IndividualActive
Sara Grotefendt, NP
NPI 1255805594 · Obstetrics & Gynecology Nurse Practitioner · Maryville, IL
Provider details
- NPI number
- 1255805594
- Entity type
- Individual
- Primary specialty
- Obstetrics & Gynecology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 209017373 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
6810 State Route 162 Ste 105
Maryville, IL 62062-8560
Phone: (618) 288-9320
Fax: (618) 288-9258
Approximate (ZIP-level) locationGet directions
Mailing address
6810 State Route 162
Maryville, IL 62062
Registry dates
- Enumerated
- 2019-01-21
- Last updated
- 2024-08-28
- Certified
- 2024-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.