Gross, Samuel Norman

Gross, Samuel Norman is an sole proprietor health care provider with primary practice located at 415 Beverly Dr , Ellinwood KS 67526-1419. He recently has only one registered license in Dietary & Nutritional Service Providers / Nutritionist, which is considered as his primary health care specialty. Gross, Samuel Norman can be contacted via phone (620) 564-2922.

Contact Information

Primary practice address
415 Beverly Dr Ellinwood KS 67526-1419
Phone: (620) 564-2922
Fax: (620) 564-2922
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X 1236 Kansas

Profile Details

NPI number 1467409862
LBN Legal business name Gross, Samuel Norman
Credentials MS.RD.LD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated Apr 24th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467409862 NPPES
Kansas Other 120533 BLUE CROSS NUTRITIONIST
Kansas MEDICAID 200366270B BLUE CROSS NUTRITIONIST

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