MRS. PAULETTE KATHLEEN GRANT (NPI# 1295763274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295763274 |
| Entity Type | Individual |
| Full Name | MRS. PAULETTE KATHLEEN GRANT |
| Credential | P.A.C. |
| Practice Address |
112 Independence Way Ste 110 Clyde OH 43410-9812 |
| Mailing Address |
Po Box 378 Sandusky OH 44871-0378 |
| Practice Telephone | 4194839000 |
| Practice Fax Number | 4194839003 |
| Mailing Telephone | 4196091112 |
| Mailing Fax Number | 4195023537 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50-00-0434 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | PHYSICIAN ASSISTANT REG | 50-00-0434 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 813 Northwest St, Bellevue, OH 448110123 | 4194839000 | 4194839003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952337032 | Paulette M Grant | Social Worker | 315 Hudson St, 2nd Floor, New York, NY 10013-1009 | 2006-06-23 |
| Street Address |
112 INDEPENDENCE WAY STE 110 |
| City | CLYDE |
| State | OH |
| Zip Code | 43410-9812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215285424 | Kim Christine Miller | Nurse Practitioner | 112 Independence Way Ste 110, Clyde, OH 43410-9812 | 2012-08-17 |
| 1275880122 | Sherri Shively | Nurse Practitioner | 112 Independence Way Ste 110, Clyde, OH 43410-9812 | 2012-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992136279 | North Coast Professional Company, LLC | Clinic/Center | 1470 West Mcpherson Highway, Clyde, OH 43410 | 2013-12-11 |
| 1346461175 | Rebecca Ann Liskai | Physical Therapy Assistant | 700 Helen Street, Clyde, OH 43410 | 2007-05-01 |
| 1043330871 | Dreffer, Hicks, & Demos O.d. Inc. | Optometrist | 1074 West Mcpherson Highway, Clyde, OH 43410 | 2007-03-29 |
| 1245339852 | David E Mileski | Physical Therapist | 119 Birdseye St, Clyde, OH 43410 | 2006-09-21 |
| 1750497632 | Paul Daniel Reed | Chiropractor | 408 and One Half E Maple St, Reed Chiropractic LLC, Clyde, OH 43410 | 2006-08-22 |
| 1740203017 | Raymond M Colavincenzo | Dentist | 243 West Maple Street, Clyde, OH 43410 | 2006-07-26 |
| 1710404652 | Tiffany C. Lancaster | Nurse Practitioner | 300 W. 10th Avenue, Columbus, OH 43410 | 2017-08-22 |
| 1548550841 | Scott Robert Sendelbach | Pharmacist | 710 North Main St, Clyde, OH 43410 | 2011-04-08 |
| 1073728135 | Victoria Ann Holmes | Occupational Therapy Assistant | 700 Helen St, Clyde, OH 43410 | 2007-05-11 |
| 1114321866 | Maria Apling | Nurse Practitioner | 112 Independence Way, Suite 150, Clyde, OH 43410-0123 | 2014-10-09 |
| Find all providers in zip 43410 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568918027 | Brandi Moziak | Physician Assistant | 262 Leroy George Dr, Clyde, NC 28721-7430 | 2016-08-25 |
| 1992972947 | Melissa F Sommerich | Physician Assistant | 15 Facility Dr, Clyde, NC 28721-9438 | 2008-05-09 |
| 1346227105 | Jon Grady | Physician Assistant | 262 Leroy George Dr, Suite M, Clyde, NC 28721-7430 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618428 | Stephanie Ann Keener | Physician Assistant | 7774 Hythe Cir, Centerville, OH 45459-8705 | 2020-10-27 |
| 1174122600 | Maria Drankov Lane | Physician Assistant | 1806 Muskegon Dr, Cincinnati, OH 45255-2635 | 2020-10-26 |
| 1326647512 | Junell Rutledge | Physician Assistant | 644 High St, Youngstown, OH 44502-1562 | 2020-10-20 |
| 1699372383 | Samantha Kibler | Physician Assistant | 7337 Caritas Cir Nw Ste 150, Massillon, OH 44646-9128 | 2020-10-06 |
| 1982218186 | Morgan Holmes | Physician Assistant | 65 Community Rd Ste F, Tallmadge, OH 44278-2358 | 2020-09-04 |
| 1902456023 | Kara Meyer | Physician Assistant | 2417 Derbyshire Ct, Cleveland Heights, OH 44106-2778 | 2019-09-19 |
| 1679122394 | Mariah Bower | Physician Assistant | 2725 Hampshire Rd Apt 3, Cleveland, OH 44106-2570 | 2019-09-05 |
| 1457908014 | Kristen Fairchild | Physician Assistant | 4235 Secor Rd Bldg 2, Toledo, OH 43623-4231 | 2019-08-19 |
| 1811549462 | Abigail Malsch | Physician Assistant | 2376 Fenwood Rd, University Heights, OH 44118-3804 | 2019-07-14 |
| 1164087466 | Jessica Lee Schulte | Physician Assistant | 1110 West Main Cross St., Findlay, OH 45840-2423 | 2019-05-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.