Provider Demographics
NPI:1396636940
Name:GROSS, ESSIE (RN)
Entity type:Individual
Prefix:
First Name:ESSIE
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 A AVE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-4505
Mailing Address - Country:US
Mailing Address - Phone:712-246-0092
Mailing Address - Fax:612-725-1254
Practice Address - Street 1:2043 A AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-4505
Practice Address - Country:US
Practice Address - Phone:712-246-0092
Practice Address - Fax:612-725-1254
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA159380163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse