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Individual
JENNIFER A GROOS
Active
Individual
JENNIFER A GROOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35505
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598747321
—
IA
01
—
175150018
MEDICARE
—
05
—
209917905
—
MO
05
—
9263738
—
CA
Enumeration date
11/17/2005
Last updated
07/20/2020
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