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

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