Gross, Theresa

Gross, Theresa is an individual health care provider with primary practice located at 121 Bishop St , Corbin KY 40701-1702. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gross, Theresa can be contacted via phone (606) 528-2124.

Contact Information

Primary practice address
121 Bishop St Corbin KY 40701-1702
Phone: (606) 528-2124
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3008942 Kentucky

Profile Details

NPI number 1144622523
LBN Legal business name Gross, Theresa
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2014
Last updated Nov 16th, 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 1144622523 NPPES
Kentucky MEDICAID 7100345190

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