Provider Demographics
NPI:1356695340
Name:GROSS, SIOBHAN MCROSTIE (RN, BSN, CDE)
Entity type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:MCROSTIE
Last Name:GROSS
Suffix:
Gender:F
Credentials:RN, BSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S. OLD DIXIE HIGHWAY
Mailing Address - Street 2:JUPITER MEDICAL CENTER
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-263-5067
Mailing Address - Fax:561-263-5048
Practice Address - Street 1:1210 S. OOLD DIXIE HWY.
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-263-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1471564163WD0400X
FL1471562163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator