NICOLE E PETGRAVE (NPI# 1649812405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649812405 |
Entity Type | Individual |
Full Name | NICOLE E PETGRAVE |
Credential | NURSE PRACTITIONER |
Practice Address |
8200 Mentor Hills Dr Mentor OH 44060-7861 |
Mailing Address |
333 N Summit St Fl 7 Toledo OH 43604-1531 |
Practice Telephone | 8004271902 |
Practice Fax Number | 4195312664 |
Mailing Telephone | 4192526018 |
Mailing Fax Number | 8005645952 |
Enumeration Date | 2019-10-14 |
Last Update Date | 2019-10-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN.CNP.024887 | OH | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
APRN.CNP.024887 | OH | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
8200 MENTOR HILLS DR |
City | MENTOR |
State | OH |
Zip Code | 44060-7861 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285676783 | Heartland of Mentor Oh LLC | Skilled Nursing Facility | 8200 Mentor Hills Dr, Mentor, OH 44060-7861 | 2006-06-11 |
1184189854 | Jozefina Diaz | Nurse Practitioner | 8200 Mentor Hills Dr, Mentor, OH 44060-7861 | 2019-02-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093364143 | Pamela Adams | Technician | 6079 Center St, Mentor, OH 44060 | 2019-09-10 |
1255800298 | Brittani Joy Lumpkin | Community/Behavioral Health | 9220 Mentor Road., Mentor, OH 44060 | 2018-11-20 |
1043726763 | Sharon Bollinger | Counselor | 7232 Tyler Blvd., Mentor, OH 44060 | 2017-12-18 |
1255863635 | Mentor Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 8151 Norton Pkwy, Mentor, OH 44060 | 2017-04-03 |
1144695933 | Kirsten Lorek | Specialist/Technologist | 8400 Paddock Ct, Mentor, OH 44060 | 2015-12-06 |
1346638848 | Darlean Williams | Licensed Practical Nurse | 6477 Center Street, Mentor High School, Mentor, OH 44060 | 2015-01-06 |
1316357130 | Kathryn Arnette Romo | Speech-Language Pathologist | 6451 Center Street, Mentor Exempted Village Schools, Mentor, OH 44060 | 2014-05-01 |
1730599705 | Marianne. P. Kostiha | Registered Nurse | 6451 Center St., Mentor Public Schools, Mentor, OH 44060 | 2014-04-30 |
1558788190 | Jeanne Marie Markusic | Physical Therapist | 7687 Ellington Pl, Mentor, OH 44060 | 2014-03-20 |
1477979391 | Center for Advanced Vein Care LLC | Emergency Medicine | 7200 Mentor Avenue, Mentor, OH 44060 | 2014-03-17 |
Find all providers in zip 44060 |
Taxonomy Code | 363LG0600X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Gerontology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215553052 | Jennifer Cordray | Nurse Practitioner | 5452 Grace Dr, Mentor, OH 44060-1500 | 2020-06-17 |
1306485859 | Katherine Mormile | Nurse Practitioner | 8316 Yellowbrick Rd, Mentor, OH 44060-4960 | 2020-01-02 |
1194188268 | Bonnie Kitchen | Nurse Practitioner | 9485 Mentor Ave Ste 210, Mentor, OH 44060-8723 | 2016-04-05 |
1508264615 | Stacie Taylor | Nurse Practitioner | 7350 Industrial Park Blvd, Mentor, OH 44060-5318 | 2014-12-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
1649879032 | Danielle Wines | Nurse Practitioner | 5933 Sarah Lake Dr, Sylvania, OH 43560-9201 | 2020-10-19 |
1881292902 | Karen Cooper | Nurse Practitioner | 730 A Kittle Road, Wheelersburg, OH 45694 | 2020-10-12 |
1659983252 | Michael A. Adams | Nurse Practitioner | 3837 Washington Blvd, University Heights, OH 44118-3158 | 2020-08-17 |
1912516709 | Susan Marie Hessey | Nurse Practitioner | 4502 Satinwood Dr, Toledo, OH 43623-3350 | 2020-07-28 |
1518585728 | Diane Louise Lamb | Nurse Practitioner | 3163 Hook Waltz Rd E, Elida, OH 45807-9555 | 2020-07-14 |
1053943134 | Chunyan Mcelroy | Nurse Practitioner | 101 Meadowlands Dr Apt D8, Chardon, OH 44024-9379 | 2020-02-06 |
1790324432 | Ashley Nicole Neely | Nurse Practitioner | 890 Oakwood Dr, Alliance, OH 44601-5435 | 2019-12-28 |
1710530357 | Christine Marie Hoover | Nurse Practitioner | 65 Community Rd Ste C, Tallmadge, OH 44278-2358 | 2019-07-23 |
1659939015 | Marcia A. Stephens Aprn LLC | Nurse Practitioner | 7450 Miami Hills Dr, Cincinnati, OH 45243-1814 | 2019-05-31 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.