Provider Demographics
NPI:1881211076
Name:GROSS, ALAYNA RENEE (LPN)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:RENEE
Last Name:GROSS
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 1:3706 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-4636
Mailing Address - Country:US
Mailing Address - Phone:513-981-1180
Mailing Address - Fax:
Practice Address - Street 1:3706 WOODBINE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4636
Practice Address - Country:US
Practice Address - Phone:513-981-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.175677.MEDS-IV164W00000X
OH402121261118376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No164W00000XNursing Service ProvidersLicensed Practical Nurse