Organization
KAYE M. GROSSNICKLE, LLC
Active
Other names
lincoln mental health
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAYE GROSSNICKLE ARNP (PRESIDENT)
(515) 955-1836
Entity
Organization
Contact information
Practice address
809 CENTRAL AVE, SUITE 420, FORT DODGE, IA 50501-3936
(515) 955-1836
(515) 955-7115
Mailing address
PO BOX 261, FORT DODGE, IA 50501-0261
(515) 955-1836
(515) 955-7115
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A063458
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0291153
—
IA
01
—
34971
BCBS NUMBER
IA
Enumeration date
07/20/2007
Last updated
01/03/2008
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