Individual
TINA MARIE SCHANTZ GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
4201 SKY FLOWER LN, SAINT CLOUD, FL 34772-8842
(321) 684-9214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9226437
FL
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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