Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 61544 | CO |
NPI | 1356511489 |
---|---|
Provider Name | Ms. Ann Marcell Gross |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2008 |
Last Update Date | 05/03/2008 |