Provider Demographics
NPI:1174297014
Name:GROSS, MARIANA CHRISTINA (WHNP)
Entity Type:Individual
Prefix:MS
First Name:MARIANA
Middle Name:CHRISTINA
Last Name:GROSS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:318-322-2140
Mailing Address - Fax:318-807-0809
Practice Address - Street 1:711 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-8435
Practice Address - Country:US
Practice Address - Phone:318-322-2140
Practice Address - Fax:318-807-0809
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA221503363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health