Provider Demographics
NPI:1972845188
Name:GRESKO, DAWN ELIZABETH (PMH-CNS)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ELIZABETH
Last Name:GRESKO
Suffix:
Gender:F
Credentials:PMH-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18660 BAGLEY RD STE 404
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3483
Mailing Address - Country:US
Mailing Address - Phone:330-690-9311
Mailing Address - Fax:216-450-1614
Practice Address - Street 1:18660 BAGLEY RD STE 404
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:404-234-8746
Practice Address - Fax:440-234-8746
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNS.13865364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3025372Medicaid
OH9389631Medicare PIN