| NPI | 1669828505 |
|---|---|
| Former Name | BREANNA RENEA GROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557452) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 115426) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2017-01-25 |