MEDICARE: SIERRA GRIEVES

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
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1003698317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA GRIEVES

Provider Business Mailing Address
First Line	:	611 BROOKFIELD DR
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-1302
Country	:	US
Telephone Number	:	937-638-3758
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 BROOKFIELD DR
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-1302
Country	:	US
Telephone Number	:	937-638-3758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	10/20/2023

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Directions to “ SIERRA GRIEVES ” Practice Location

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