Provider Demographics
NPI:1972632529
Name:GRIPPI, PATRICIA A (APN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:GRIPPI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 ELK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004
Mailing Address - Country:US
Mailing Address - Phone:440-964-3005
Mailing Address - Fax:
Practice Address - Street 1:8701 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6103
Practice Address - Country:US
Practice Address - Phone:440-266-0770
Practice Address - Fax:440-266-0257
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-07681364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0522849Medicaid
OHGRNS02782Medicare ID - Type Unspecified
OH0522849Medicaid