Individual
KIMBERLY ANNA GROSSNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
46B THOMAS JOHNSON DR STE 200, FREDERICK, MD 21702-4501
(301) 695-6777
Mailing address
11720 BELTSVILLE DR STE 300, BELTSVILLE, MD 20705-3119
(240) 223-1799
(832) 348-5791
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R200925
MD
363LF0000X
Family Nurse Practitioner
Primary
R200925
MD
Other
Enumeration date
02/14/2019
Last updated
01/11/2023
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