Nancy Perkins Grossman, DO

Individual provider Active NPI Psychiatry Physician · Hernando, FL

NPI 1154472330 · NPPES record last updated Jan 18, 2012

Key facts

NPI
1154472330
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
25MB04084200 (NJ)
Practice address
1390 W Double Eagle CT
Hernando, FL 34442-6240
Phone
(352) 746-1776
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2229WVMDMental Health Counselor
25MB04084200NJMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MB04084200 NJ Yes

Addresses

Primary practice location

1390 W Double Eagle CT
Hernando, FL 34442-6240

Mailing address

1390 W Double Eagle CT
Hernando, FL 34442-6240
Phone (352) 746-1776

Other providers in Hernando, FL

All providers in Hernando, FL · Psychiatry Physician in Florida

Sources for this page

Verify at the official NPI Registry.