Provider Demographics
NPI:1477247088
Name:GRIZZEL, BOBBI JEAN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BOBBI
Middle Name:JEAN
Last Name:GRIZZEL
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 1:950 LILA AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1683
Mailing Address - Country:US
Mailing Address - Phone:513-900-9578
Mailing Address - Fax:
Practice Address - Street 1:950 LILA AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1683
Practice Address - Country:US
Practice Address - Phone:513-900-9578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-112356164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse