Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole E Petgrave, NURSEPRACTITIONER

Individual provider Adult Health Nurse Practitioner · NPI 1649812405

Nicole E Petgrave, NURSEPRACTITIONER is a Nurse Practitioner in Mentor, Ohio. Qualified in 2019, 7 years ago. Practices with Mills Medical Practices LLC, a 25-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

8200 Mentor Hills Dr
Mentor, OH 44060-7861
Phone: (800) 427-1902
Fax: (419) 531-2664
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence APRN.CNP.024887 (OH)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence APRN.CNP.024887 (OH)

Record details

NPI number1649812405
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedOctober 14, 2019
Last updated in NPPESOctober 15, 2019
Mailing address333 N Summit St Fl 7, Toledo, OH 43604-1531

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mills Medical Practices Llc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Mentor