Individual
BLAIR NICHOLE GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1861 E MAPLE RD, TROY, MI 48083-4207
(248) 246-0172
Mailing address
5247 WOODLANE RD, CLARKSTON, MI 48348-3165
(586) 770-8100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704309632
MI
Other
Enumeration date
08/03/2017
Last updated
08/26/2024
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