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Contact Information

MALLORY W GROSE, ANP-C
694 RIVERSIDE DR
MOUNT AIRY, NC27030
 Phone: 336-719-7892
 Fax: 336-719-7898
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Adult Health

363LA2200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MALLORY W GROSE · (Female)

NPI Number 1093089575
Status Active
Credentials ANP-C
Entity Individual
Enumeration date 03/01/2012
Last updated 08/02/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NC License # 363LA2200X
  • NC License # 5005508
Hospital affiliation(s)
  • FORSYTH MEMORIAL HOSPITAL - (Acute Care)
    3333 SILAS CREEK PARKWAY
    WINSTON-SALEM, NC 27103
  • NORTHERN HOSPITAL OF SURRY COUNTY - (Acute Care)
    830 ROCKFORD ST
    MOUNT AIRY, NC 27030
  • TWIN COUNTY REGIONAL HOSPITAL - (Acute Care)
    200 HOSPITAL DRIVE
    GALAX, VA 24333
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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