Provider Demographics
NPI:1205415452
Name:GRASSICK, PAMELA ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANN
Last Name:GRASSICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:DEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:2054 MILLSBORO RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3329
Mailing Address - Country:US
Mailing Address - Phone:419-565-8010
Mailing Address - Fax:
Practice Address - Street 1:1941 S BANEY RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4502
Practice Address - Country:US
Practice Address - Phone:419-289-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028322363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care