Individual
JESSICA L GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3029 SMITH RD, SUITE 400, FAIRLAWN, OH 44333-3370
(330) 670-9400
(330) 670-9401
Mailing address
3029 SMITH RD, SUITE 400, FAIRLAWN, OH 44333-3370
(330) 670-9400
(330) 670-9401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
14531
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14531
LICENSE
OH
Enumeration date
06/11/2013
Last updated
06/11/2013
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