MEDICARE: DR. ROSALYN GROSS ARNP, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	201250113NP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336127398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSALYN GROSS ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	6542 SE LAKE RD
Second Line	:	#202
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-2244
Country	:	US
Telephone Number	:	503-654-5636
Fax Number	:

Provider Business Practice Location Address
First Line	:	6542 SE LAKE RD
Second Line	:	#202
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-2244
Country	:	US
Telephone Number	:	503-654-5636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	11/19/2014

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