Provider Demographics
NPI:1275906646
Name:GRAYSON, RASHEDA (LPN)
Entity Type:Individual
Prefix:
First Name:RASHEDA
Middle Name:
Last Name:GRAYSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18608 MAPLE HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-2246
Mailing Address - Country:US
Mailing Address - Phone:216-339-9709
Mailing Address - Fax:
Practice Address - Street 1:18608 MAPLE HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-2246
Practice Address - Country:US
Practice Address - Phone:216-339-9709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-07
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 125913-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse