Individual
LISA GROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
639 CARONDELET ST, MANDEVILLE, LA 70448-5004
(985) 626-4428
Mailing address
545 BEAU CHENE DR, MANDEVILLE, LA 70471-1779
(504) 909-5636
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
088602
LA
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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