Mary Jo Grabe, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Brookpark, OH

NPI 1508308370 · NPPES record last updated Nov 10, 2016

Key facts

NPI
1508308370
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN-062031 (OH)
Practice address
16900 Holland Rd
Brookpark, OH 44142-3522
Phone
(216) 898-8686
Fax
(216) 676-2073
NPI assigned
Nov 10, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN-062031OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN-062031 OH Yes

Addresses

Primary practice location

16900 Holland Rd
Brookpark, OH 44142-3522

Mailing address

16900 Holland Rd
Brookpark, OH 44142-3522
Phone (216) 898-8686

Other providers in Brookpark, OH

All providers in Brookpark, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.