Individual
MS. MARY NOEL GROSSKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2915 E BASELINE RD, SUITE 101, GILBERT, AZ 85234-2425
(480) 776-0626
(480) 776-0627
Mailing address
1345 E ROCKLEDGE RD, PHOENIX, AZ 85048-6215
(602) 403-1110
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP4025
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP4025
STATE NURSE PRACTIONER LICENSE
AZ
Enumeration date
06/17/2011
Last updated
07/19/2011
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