Provider Demographics
NPI:1811467947
Name:GRIP, NORMA JEAN (LPN)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:GRIP
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 1:321 BERNICE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-2101
Mailing Address - Country:US
Mailing Address - Phone:585-329-9953
Mailing Address - Fax:
Practice Address - Street 1:321 BERNICE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-2101
Practice Address - Country:US
Practice Address - Phone:585-329-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285227164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse