Individual
AMANDA FAYE GROSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3219 CENTRAL AVE, KEARNEY, NE 68847-2949
(308) 865-2370
Mailing address
1824 W 12TH ST, HASTINGS, NE 68901-3647
(402) 812-6322
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
87970
NE
363LA2100X
Acute Care Nurse Practitioner
Primary
114198
NE
Other
Enumeration date
03/24/2022
Last updated
06/07/2022
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