NICOLE E PETGRAVE NURSE PRACTITIONER NPI 1649812405

NPI Information

NPI: 1649812405
Provider Name: NICOLE E PETGRAVE, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
8200 MENTOR HILLS DR
MENTOR, OH
ZIP 44060
Phone: (800) 427-1902
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Nicole E Petgrave, NURSE PRACTITIONER is a gerontology nurse practitioner in Mentor, OH with 5 years of experience. Nicole E Petgrave, NURSE PRACTITIONER NPI is 1649812405. 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:

8200 MENTOR HILLS DR
MENTOR, OH
ZIP 44060-861
Phone: (800) 427-1902
Fax: (419) 531-2664

The NPI 1649812405 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/14/2019 and was last updated on 10/15/2019.

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
1	363LA2200X	Nurse Practitioner	Adult Health	APRN.CNP.024887	OHIO	No
2	363LG0600X	Nurse Practitioner	Gerontology	APRN.CNP.024887	OHIO	Yes

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: 4/28/2024

NPI Synchronization or Removal

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