Provider Demographics
NPI:1578288296
Name:MCGRAW, JOLITTA VINCENTTA (LPN)
Entity Type:Individual
Prefix:
First Name:JOLITTA
Middle Name:VINCENTTA
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JOLITTA
Other - Middle Name:VINCENTTA
Other - Last Name:IORFIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:154 BRANDTSON AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-3932
Mailing Address - Country:US
Mailing Address - Phone:330-635-6402
Mailing Address - Fax:
Practice Address - Street 1:347 MIDWAY BLVD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-9006
Practice Address - Country:US
Practice Address - Phone:440-324-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.164791.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse