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General NPI Number Information
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NPI Number | 1477308898
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Entity Type | Individual
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Provider Name | KIMBERLY GROSS NP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 700 MARVEL RD
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City | MILFORD
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State | DE
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Zip | 19963-1740
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Country | US
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Telephone | 855-669-4788
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 DARLING DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-8508
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Country | US
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Telephone | 302-220-6204
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0012737
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License Number State | DE
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