Brianna Grosso, | |
3003 University Dr, Marinette, WI 54143-4110 | |
(715) 735-4200 | |
Not Available |
Full Name | Brianna Grosso |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 3003 University Dr, Marinette, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396354320 | NPI | - | NPPES |
7157354200 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (Wisconsin) | Primary |
Provider Name | Oneida Nation |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1740278308 PECOS PAC ID: 6800794074 Enrollment ID: O20031224000077 |
Mailing Address | Practice Location Address |
---|---|
Brianna Grosso, 3003 University Dr, Marinette, WI 54143-4110 Ph: () - | Brianna Grosso, 3003 University Dr, Marinette, WI 54143-4110 Ph: (715) 735-4200 |
Danielle L Denruyter, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3100 Shore Dr, Marinette, WI 54143 Phone: 715-735-4200 | |
Brooke Ashton Villalpando, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3003 University Dr, Marinette, WI 54143 Phone: 715-735-4200 | |
Jena K Doemel, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3100 Shore Dr, Marinette, WI 54143 Phone: 715-732-4200 | |
Vanessa Victoria Vincent, RD Dietitian Medicare: Medicare Enrolled Practice Location: 2820 Roosevelt Rd, Marinette, WI 54143 Phone: 715-735-5225 Fax: 715-735-5388 | |
Nola M Hardy, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 3130 Shore Dr, Marinette, WI 54143 Phone: 715-735-7421 | |
Jean Bouche, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3100 Shore Dr, Dietary, Marinette, WI 54143 Phone: 715-735-4200 Fax: 715-735-8017 |