Provider Demographics
NPI:1285369066
Name:GRAYSON, JASMINE DIANE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:DIANE
Last Name:GRAYSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:DIANE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-7449
Mailing Address - Fax:614-366-2360
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-7449
Practice Address - Fax:614-366-2360
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.404016363LA2100X
OHAPRNCNP0032580363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care