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Individual
MRS. TAMMY MICHELLE GROSS
Active
Individual
MRS. TAMMY MICHELLE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006534
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100134760
—
KY
01
—
P400039548
MEDICARE PTAN
KY
Enumeration date
07/26/2010
Last updated
02/11/2014
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