Provider Demographics
NPI:1902287345
Name:STEAD, GINNI
Entity Type:Individual
Prefix:
First Name:GINNI
Middle Name:
Last Name:STEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39199 PARSONS RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-9743
Mailing Address - Country:US
Mailing Address - Phone:440-223-6783
Mailing Address - Fax:
Practice Address - Street 1:39199 PARSONS RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-9743
Practice Address - Country:US
Practice Address - Phone:440-223-6783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH322211360911Medicaid