Patricia Gross, LPN

Individual provider Active NPI Licensed Practical Nurse · Shepherd, MI

NPI 1255760583 · NPPES record last updated Nov 7, 2013

Key facts

NPI
1255760583
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703054533 (MI)
Practice address
460 N Cottage Ave Apt a
Shepherd, MI 48883-9084
Phone
(989) 567-2077
NPI assigned
Nov 7, 2013
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)
No

State licenses

LicenseStateTypeSpecialty
4703054533MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703054533 MI Yes

Addresses

Primary practice location

460 N Cottage Ave Apt a
Shepherd, MI 48883-9084

Mailing address

460 N Cottage Ave Apt a
Shepherd, MI 48883-9084
Phone (989) 567-2077

Other providers in Shepherd, MI

All providers in Shepherd, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.