Provider Demographics
NPI:1992125223
Name:GROSSI, GERI LYNN (NP)
Entity type:Individual
Prefix:MRS
First Name:GERI
Middle Name:LYNN
Last Name:GROSSI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:GERI
Other - Middle Name:LYNN
Other - Last Name:GINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3050 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3819
Mailing Address - Country:US
Mailing Address - Phone:108-385-4441
Mailing Address - Fax:810-385-1951
Practice Address - Street 1:1231 PINE GROVE AVE STE 2A
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3500
Practice Address - Country:US
Practice Address - Phone:810-982-8742
Practice Address - Fax:810-984-8291
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704216985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily