Individual
TRISTA LOUISE GROSSNICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
400 W GLENN MILLER DR, CLARINDA, IA 51632-2963
(712) 542-8354
(712) 517-1192
Mailing address
400 W GLENN MILLER DR, CLARINDA, IA 51632-2963
(712) 542-8354
(712) 517-1192
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G167240
IA
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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