Healthcare Provider Details

I. General information

NPI: 1083962401
Provider Name (Legal Business Name): MEGAN M GROSS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN M SOOD

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 CEDAR CROSS RD STE 1002
DUBUQUE IA
52003-7890
US

IV. Provider business mailing address

1225 KELLY LN
DUBUQUE IA
52003-8542
US

V. Phone/Fax

Practice location:
  • Phone: 563-227-3835
  • Fax: 563-279-0652
Mailing address:
  • Phone: 952-270-8260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number129015
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberB129015
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: