Individual
MRS. KIMBERLY J GRALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
S.T.N.A.
Contact information
Practice address
165 BRIARLEIGH DR, BRUNSWICK, OH 44212-1430
(330) 273-9576
Mailing address
165 BRIARLEIGH DR, BRUNSWICK, OH 44212-1430
(330) 273-9576
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
371904970192
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368450
STATE PROVIDER NUMBER
OH
01
—
371904970192
S.T.N.A.
OH
Enumeration date
12/16/2006
Last updated
07/08/2007
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