Provider Demographics
NPI:1912314535
Name:GROSS, KERRYANN (CRNP)
Entity type:Individual
Prefix:
First Name:KERRYANN
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KERRYANN
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:19 DONALD DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1540
Mailing Address - Country:US
Mailing Address - Phone:410-419-1968
Mailing Address - Fax:
Practice Address - Street 1:7112 DARLINGTON DR
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-7013
Practice Address - Country:US
Practice Address - Phone:410-670-9063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR182057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily