Individual
KRISTIN GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82 PARMETTA CIR, WAVERLY, WV 26184-3349
(304) 966-4697
Mailing address
82 PARMETTA CIR, WAVERLY, WV 26184-3349
(304) 966-4697
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
38596
WV
164W00000X
Licensed Practical Nurse
LPN.176479.MEDS
OH
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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