KRISTIN MARIE GROESSL


Address: 260 Hospital Dr Ste 107, Ukiah, CA 95482
Phone: 7074637627

KRISTIN MARIE GROESSL (NPI# 1093797250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093797250
Entity Type Individual
Full Name KRISTIN MARIE GROESSL
Credential PA-C
Practice Address 260 Hospital Dr Ste 107
Ukiah
CA 95482
Mailing Address 260 Hospital Dr Ste 107
Ukiah
CA 95482-4568
Practice Telephone 7074637627
Enumeration Date 2005-11-15
Last Update Date 2018-11-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363A00000X Physician Assistant 1164-023 WI Physician Assistants & Advanced Practice Nursing Providers
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
56266 CA Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
1164-023 WI Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
12203 Corporate Pkwy, Mequon, WI 530923388 2623878200 2623878271

Office Location

Street Address 260 HOSPITAL DR STE 107
City UKIAH
State CA
Zip Code 95482

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447647771 Brian Scott Gould Family Medicine 260 Hospital Dr Ste 107, Ukiah, CA 95482-4568 2015-04-24
1386957785 Ephraim Dickinson Orthopaedic Surgery 260 Hospital Dr Ste 107, Ukiah, CA 95482 2010-07-15
1922334671 Mark E. Trump Orthopaedic Surgery 260 Hospital Dr Ste 107, Ukiah, CA 95482 2009-10-29
1932152667 Adrian B Obuch Orthopaedic Surgery 260 Hospital Dr Ste 107, Ukiah, CA 95482 2006-05-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932726726 Gloria Gonzalez Campise Midwife 205 W. Clay Street, Ukiah, CA 95482 2020-06-29
1083255095 Mendocino Care Network Internal Medicine 1080 N State St, Ukiah, CA 95482 2019-10-01
1801383153 Costco Wholesale Corporation Pharmacy 1275 Airport Park Blvd., Ukiah, CA 95482 2018-04-21
1922528256 Ian David Winter Case Manager/Care Coordinator 1120 S. Dora St, Ukiah, CA 95482 2017-06-27
1568917938 Rebecca Ann Dragomani Nurse Practitioner 260 Hospital Dr Ste 101, Ukiah, CA 95482 2016-08-16
1811362536 Manzanita Services, Inc. Community/Behavioral Health 410 W. Jones St., Ukiah, CA 95482 2015-12-07
1689061061 Pamela Mathias Counselor 367 East Gobbi Street, Suite E, Ukiah, CA 95482 2015-04-23
1275927030 Jack David Segel Counselor 564 Dora St., Ste.d, Ukiah, CA 95482 2015-03-19
1689070211 Mendocino County Youth Project Clinic/Center 347 Plum St, #b, Ukiah, CA 95482 2014-11-10
1346649951 Ae Ran Ku Dentist 1096 South Dora Street, Ukiah, CA 95482 2014-08-19
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

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1578049458 Ida Jelveh Physician Assistant 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 2018-07-13
1356833578 Michael James Gonzalez Physician Assistant 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 2018-06-04
1023500592 Pamela Lambert Pa-c, Inc. Physician Assistant 16105 Mariposa Ave, Riverside, CA 92504-8730 2018-05-31
1225532385 Folsom Physicain Assistant First Assist, Inc Physician Assistant Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 2018-03-22
1275040008 Gm Surgical Assistant Inc Physician Assistant 15615 Turnberry St, Moreno Valley, CA 92555-4901 2018-01-02
1902311186 Or Solutions Inc Physician Assistant 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 2017-12-09
1184143828 Alaa Abdalla Daghlas Physician Assistant 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 2017-09-13
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Competitor

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City UKIAH
Zip Code 95482

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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