Provider Demographics
NPI:1447648142
Name:GRANDINETTI, CAROLINA (STNA)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:GRANDINETTI
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4441 PERRY CIR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5946
Mailing Address - Country:US
Mailing Address - Phone:216-856-2402
Mailing Address - Fax:
Practice Address - Street 1:4441 PERRY CIR
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-5946
Practice Address - Country:US
Practice Address - Phone:216-856-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401706581214376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide