Provider Demographics
NPI:1508931510
Name:GROSSE, JESSICA ELIZABETH BORO (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELIZABETH BORO
Last Name:GROSSE
Suffix:
Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:7100 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2714
Mailing Address - Country:US
Mailing Address - Phone:402-506-9000
Mailing Address - Fax:402-506-9093
Practice Address - Street 1:7100 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2714
Practice Address - Country:US
Practice Address - Phone:402-506-9000
Practice Address - Fax:402-506-9093
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2020-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE1336363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant