Provider Demographics
NPI:1861823676
Name:GRAZIANI, JACQUELINE MARIE (CNP)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MARIE
Last Name:GRAZIANI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 KOLBE RD STE 223
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-222-4661
Mailing Address - Fax:440-222-4662
Practice Address - Street 1:3600 KOLBE RD STE 223
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4661
Practice Address - Fax:440-222-4662
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15416-NP363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care