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MRS. MELODI MARIE GROSS LPN

>> Licensed Practical Nurse >> Nursing Service Providers

Registrant NPI Number: 1124179684

Individual Registrant:
MRS. MELODI MARIE GROSS LPN
Gender: F
Sole Proprietor

Location and contact information for practice:
14814 FORD RD  MADISON, OH 44057-9528 US
Tel: 440-628-4523  Fax: --

Contact information for business:
PO BOX 401  NORTH KINGSVILLE, OH 44068-0401 US
Tel: 440-224-2973  Fax: --

Registration Information:
NPI: 1124179684
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y164W00000XNursing Service Providers
Licensed Practical Nurse
OHPN-107145

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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