Individual
NICOLE E PETGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8200 MENTOR HILLS DR, MENTOR, OH 44060-7861
(800) 427-1902
(419) 531-2664
Mailing address
333 N SUMMIT ST FL 7, TOLEDO, OH 43604-1531
(419) 252-6018
(800) 564-5952
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN.CNP.024887
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.024887
OH
Other
Enumeration date
10/14/2019
Last updated
10/15/2019
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