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Individual
RICHELLE MARIE VANDAGRIFF
Active
Individual
RICHELLE MARIE VANDAGRIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN136200-M-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3071581
—
OH
Enumeration date
07/07/2010
Last updated
08/02/2011
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