Provider Demographics
NPI:1477338226
Name:GRUND, SANDRA MARIE (CNA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MARIE
Last Name:GRUND
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:MARIE
Other - Last Name:WETSHTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1915 STATE ROUTE 59 LOT 54
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-7602
Mailing Address - Country:US
Mailing Address - Phone:234-499-0142
Mailing Address - Fax:
Practice Address - Street 1:1915 STATE ROUTE 59 LOT 54
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-7602
Practice Address - Country:US
Practice Address - Phone:234-499-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide