Provider Demographics
NPI:1316216450
Name:GROSS, RUKHSANA MUNAF (FNP-C)
Entity Type:Individual
Prefix:
First Name:RUKHSANA
Middle Name:MUNAF
Last Name:GROSS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1650 BRIDLE PATH CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-9016
Mailing Address - Country:US
Mailing Address - Phone:925-980-1565
Mailing Address - Fax:
Practice Address - Street 1:1650 BRIDLE PATH CT
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-9016
Practice Address - Country:US
Practice Address - Phone:925-980-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily