Healthcare Provider Details

I. General information

NPI: 1336115377
Provider Name (Legal Business Name): SUE A GREBER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 GLEN ESTE WITHAMSVILLE RD
CINCINNATI OH
45245
US

IV. Provider business mailing address

4701 CREEK RD STE 110
CINCINNATI OH
45242
US

V. Phone/Fax

Practice location:
  • Phone: 513-753-7488
  • Fax: 513-753-7879
Mailing address:
  • Phone: 513-733-9333
  • Fax: 513-588-2479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberOH RN135071
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: