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NPI Code Detail

MEDICARE: JILL GRABOSKY RN

MEDICARE: JILL GRABOSKY RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0400XCase Management Registered Nurse73634WV

General Provider Information

NPI Number : 1770193666
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL GRABOSKY RN
Provider Business Mailing Address
First Line : 353 KENNA DR
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25309-2656
Country : US
Telephone Number : 304-610-1808
Fax Number :
Provider Business Practice Location Address
First Line : 4329 HUGHES BRANCH RD
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-9768
Country : US
Telephone Number : 304-733-6415
Fax Number : 304-733-6429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2020
Last Update Date : 08/05/2020

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