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Individual

MS. COURTNEY BROOKE GRAVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, RN

Contact information

Practice address
8655 MARKET STREET, MENTOR, OH 44060
(440) 255-6400
(440) 255-3637
Mailing address
5141 SHEPHERDS GLN, WILLOUGHBY, OH 44094-3388
(440) 487-8508

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.16149-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0106908
OH
Enumeration date
08/04/2010
Last updated
06/15/2022
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