Individual
JENNA GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
81 1ST ST NW, BLACKDUCK, MN 56630-2228
(218) 835-4222
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R 199200-7
MN
363LF0000X
Family Nurse Practitioner
Primary
3964
MN
Other
Enumeration date
07/07/2015
Last updated
07/10/2024
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