Van Groll, Sandra R
Van Groll, Sandra R is an individual health care provider with primary practice located at 5300 Memorial Dr , Two Rivers WI 54241-3923. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Van Groll, Sandra R can be contacted via phone (920) 793-7337.Contact Information
Primary practice address
5300 Memorial Dr
Two Rivers WI 54241-3923
Phone: (920) 793-7337
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 7927 | Wisconsin |
Profile Details
| NPI number | 1659898385 |
|---|---|
| LBN Legal business name | Van Groll, Sandra R |
| Credentials | APNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2017 |
| Last updated | Oct 4th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659898385 | NPPES |
| Wisconsin | MEDICAID | 100071520 |
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