Provider Demographics
NPI:1770115685
Name:GRIER, NICHOLE ELIZABETH
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:ELIZABETH
Last Name:GRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 MARRA DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3024
Mailing Address - Country:US
Mailing Address - Phone:216-358-8585
Mailing Address - Fax:
Practice Address - Street 1:5927 MARRA DR
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-3024
Practice Address - Country:US
Practice Address - Phone:216-358-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care