Provider Demographics
NPI:1699385765
Name:RUNYON, GRACE ANN (BA)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ANN
Last Name:RUNYON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OAK ST FL 7
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2505
Mailing Address - Country:US
Mailing Address - Phone:513-808-0105
Mailing Address - Fax:
Practice Address - Street 1:400 OAK ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2505
Practice Address - Country:US
Practice Address - Phone:513-808-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator