Provider Demographics
NPI:1376333450
Name:GRINE, BAYLEE FAY
Entity type:Individual
Prefix:
First Name:BAYLEE
Middle Name:FAY
Last Name:GRINE
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 1:15529 BEERBOWER RD
Mailing Address - Street 2:
Mailing Address - City:NEY
Mailing Address - State:OH
Mailing Address - Zip Code:43549-9746
Mailing Address - Country:US
Mailing Address - Phone:419-551-9521
Mailing Address - Fax:
Practice Address - Street 1:15529 BEERBOWER RD
Practice Address - Street 2:
Practice Address - City:NEY
Practice Address - State:OH
Practice Address - Zip Code:43549-9746
Practice Address - Country:US
Practice Address - Phone:419-551-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant