Individual
JANA GROSSHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2300 E 30TH ST BLDG A, FARMINGTON, NM 87401-8991
(505) 326-6400
(505) 326-4606
Mailing address
1515 E 20TH ST STE A, FARMINGTON, NM 87401-9039
(505) 326-6400
(505) 326-4606
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
144782
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
54968
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518999853
—
UT
05
—
26379562
—
NM
05
—
444549
—
AZ
05
—
68527578
—
CO
05
—
915256317
—
MO
01
—
P00753281
RR MEDICARE
NM
Enumeration date
07/07/2006
Last updated
02/11/2014
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