Gross, Lisa Nicole

Gross, Lisa Nicole is an individual health care provider with primary practice located at 4410 Pennsylvania Ave Apt 4 , Kansas City MO 64111-3323. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Gross, Lisa Nicole can be contacted via phone (785) 766-5412.

Contact Information

Primary practice address
4410 Pennsylvania Ave Apt 4 Kansas City MO 64111-3323
Phone: (785) 766-5412
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 24-00642 Kansas

Profile Details

NPI number 1043458532
LBN Legal business name Gross, Lisa Nicole
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2009
Last updated Jan 22nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043458532 NPPES
Kansas Other 24-00642 KANSAS STATE BOARD OF HEALING ARTS

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