Provider Demographics
NPI:1326302795
Name:GROSS, KRISTINA M (RN, CNP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:GROSS
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4498
Mailing Address - Country:US
Mailing Address - Phone:320-308-3193
Mailing Address - Fax:320-308-3192
Practice Address - Street 1:720 4TH AVE S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4442
Practice Address - Country:US
Practice Address - Phone:320-308-3193
Practice Address - Fax:320-308-3192
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR-1401585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily