Grosse-Macemon, Susan

Grosse-Macemon, Susan is an individual health care provider with primary practice located at 153 Cesar Chavez St , W. St. Paul MN 55107-2226. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Grosse-Macemon, Susan can be contacted via phone (651) 222-1816.

Contact Information

Primary practice address
153 Cesar Chavez St W. St. Paul MN 55107-2226
Phone: (651) 222-1816
Fax: (651) 222-2226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1451 Minnesota

Profile Details

NPI number 1922060169
LBN Legal business name Grosse-Macemon, Susan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated May 23rd, 2019 - about 6 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 1922060169 NPPES
Minnesota MEDICAID 153842000
Minnesota Other 923911025971
Minnesota Other 0102292
Minnesota Other 108562
Minnesota Other 53M29GR
Minnesota Other HP26519

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