M JILL GRONHOLZ-DERO NPI 1093700593

NPI Information

  • NPI: 1093700593
  • Provider Name: M JILL GRONHOLZ-DERO
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 914 W IRONWOOD DR
    COEUR D ALENE, ID
    ZIP 83814
  • Phone: (208) 765-5922

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NPI Details

M Jill Gronholz-dero is a family medicine in Coeur D Alene, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. M Jill Gronholz-dero NPI is 1093700593. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

914 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814-927
Phone: (208) 765-5922
Fax: (208) 664-3169

The enumeration date for this NPI number is 9/12/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine0-45IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11302782MEDICARE ID-TYPE UNSPECIFIEDIDAHO
21790296MEDICARE ID-TYPE UNSPECIFIEDIDAHO
3E19318MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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