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Individual
GENNA MARIE GRONDIN
Active
Individual
GENNA MARIE GRONDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704386893
MI
363LF0000X
Family Nurse Practitioner
903237
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03774317
—
MS
Enumeration date
05/24/2019
Last updated
08/14/2023
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