Individual
JENNIFER L GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2014 JEFFERSON RD, NORTHFIELD URGENT CARE, NORTHFIELD, MN 55057-3251
(507) 664-9999
(507) 664-3954
Mailing address
1524 LIBERTY CIR, SHAKOPEE, MN 55379-4545
(612) 743-5210
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10216
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
896493000
—
MN
Enumeration date
12/05/2006
Last updated
01/18/2010
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