Doctor Name: | JENNIFER J. GRADEL |
NPI Number: | 1700202959 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | 2010004559 |
Business Practice Address: | 1050 W 10th St Ste 480 Rolla, MO - 654012905 |
Business Phone Number: | 5734264455 |
Business Fax Number: | 5734264454 |
Mailing Address: | 1050 W 10th St, Ste 480 ROLLA |
State: | MO |
Postal Code: | 654012905 |
Phone Number: | 5734264455 |
Fax Number: | 5734264454 |
NPI Enumeration Date: | 03/12/2014 |
NPI Last Update Date: | 03/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 2010004559 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |