Provider Demographics
NPI:1366036295
Name:VINESKY, GRACE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:VINESKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1934
Mailing Address - Country:US
Mailing Address - Phone:440-787-7233
Mailing Address - Fax:
Practice Address - Street 1:100 NORMAN AVE
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1934
Practice Address - Country:US
Practice Address - Phone:440-787-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH456839163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse