Individual
GRACE MARIE DEYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC, PHD
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-2000
Mailing address
700 CHILDRENS DRIVE, COLUMBUS, OH 43205-2664
(614) 722-2461
(614) 722-4565
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.09603
OH
363LP2300X
Primary Care Nurse Practitioner
APRN.CNP.09603
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3015516
—
OH
01
—
H179601
CGS-MEDICARE
OH
Enumeration date
09/05/2007
Last updated
02/25/2022
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