Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Jean Grossman, CNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1629897160

Kelly Jean Grossman, CNP is a Nurse Practitioner in Saint Paul, Minnesota. Qualified in 2024, 2 years ago. Practices with Susan Borden Psych, a 10-clinician group and works from 2 locations. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2024
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

2303 Wycliff St Ste W210
Saint Paul, MN 55114-1272
Phone: (612) 424-0434
Fax: (877) 905-7069
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6204 Cascade Pass, Chanhassen, MN 55317-9475 — (913) 645-7599

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 12166 (MN)

Record details

NPI number1629897160
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorYes
NPI enumeratedOctober 9, 2024
Last updated in NPPESOctober 9, 2024
Certification dateOctober 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Susan Borden Psych — 10 clinicians
Accepts Medicare assignment Not indicated

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