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General NPI Number Information
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NPI Number | 1336411479
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Entity Type | Individual
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Provider Name | GRISELLE COSS
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Gender | Female
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | BO ARENA CARR 734 KM 0.5
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-641-9133
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 74710
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-9313
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Country | US
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Telephone | 787-460-0204
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 31428
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License Number State | PR
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