| Doctor Name: | JOAN GROTEWOLD |
| NPI Number: | 1003190372 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNP |
| License Number: | R104949 |
| Business Practice Address: | 5067 55th St Sw Rochester, MN - 559014717 |
| Business Phone Number: | 5072927070 |
| Business Fax Number: | |
| Mailing Address: | 5067 55th St Sw, ROCHESTER |
| State: | MN |
| Postal Code: | 559014717 |
| Phone Number: | 5072927070 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2011 |
| NPI Last Update Date: | 10/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R104949 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |