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General NPI Number Information
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NPI Number | 1770193666
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Entity Type | Individual
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Provider Name | JILL GRABOSKY RN
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Gender | Female
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 4329 HUGHES BRANCH RD
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City | HUNTINGTON
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State | WV
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Zip | 25701-9768
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Country | US
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Telephone | 304-733-6415
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Fax | 304-733-6429
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Provider Business Mailing Address
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Address Line | 353 KENNA DR
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-2656
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Country | US
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Telephone | 304-610-1808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 73634
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License Number State | WV
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