Individual
STACY ANN GROSSMAN
Active
Individual
STACY ANN GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7591
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7591
MEDICAID
MN
05
—
7591
—
MN
Enumeration date
08/28/2020
Last updated
04/11/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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