Gravens, Courtney Brooke

Gravens, Courtney Brooke is an sole proprietor health care provider with primary practice located at 8655 Market Street , Mentor OH 44060. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gravens, Courtney Brooke can be contacted via phone (440) 255-6400.

Contact Information

Primary practice address
8655 Market Street Mentor OH 44060
Fax: (440) 255-3637
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.16149-NP Ohio

Profile Details

NPI number 1467766261
LBN Legal business name Gravens, Courtney Brooke
Credentials MSN, RN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2010
Last updated Jun 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467766261 NPPES
Ohio MEDICAID 0106908

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