Basic Information
| Provider Information | |||||||||
| NPI: | 1881840411 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRONSETH | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | MICHELE STEINEMANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ANP-BC, GNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10116 BROOKSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554312825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528850564 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 E 28TH ST | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554073723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128633900 | ||||||||
| FaxNumber: | 6128633784 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2008 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | R-158693-4 | MN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LA2200X | R-158693-4 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.