Individual
ROBERTA R GRIDLEY
Active
Individual
ROBERTA R GRIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28188662A
IN
163W00000X
Registered Nurse
RN.491585
OH
164W00000X
Licensed Practical Nurse
27056431A
IN
363LA2100X
Acute Care Nurse Practitioner
2024085294
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0037844
OH
Other
Enumeration date
06/21/2007
Last updated
11/29/2024
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