Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 0024180401 | VA |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | R229373 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | 0024180401 | VA |
N | 363LP2300X | Nurse Practitioner - Primary Care | R229373 | MD |
NPI | 1053920751 |
---|---|
Provider Name | Dr. Sarah Michele Gross |
First Address | Frederick, MD 21702-5126 |
Second Address | Frederick, MD 21702-5126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2020 |
Last Update Date | 13/08/2021 |