Individual
HEATHER LYNN GROSSKLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2304040
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500649381
—
OR
01
—
R166444
PTAN
—
Enumeration date
09/06/2012
Last updated
06/14/2022
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