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Individual

MRS. VICKI LYNN GROSSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN MSN APRN

Contact information

Practice address
1915 NE STUCKI AVE STE 308, HILLSBORO, OR 97006-6951
(303) 352-3316
Mailing address
1915 NE STUCKI AVE STE 308, HILLSBORO, OR 97006-6951
(303) 352-3316

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
93197
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202207534NPPP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
93197
CO
364S00000X
Clinical Nurse Specialist
93197
CO

Other

Enumeration date
10/26/2005
Last updated
10/30/2023
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