Basic Information
| Provider Information | |||||||||
| NPI: | 1376543397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAF | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | ROSEMARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1620 NORTHWEST OUTRIGGER LOOP | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982770000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606759528 | ||||||||
| FaxNumber: | 3606759369 | ||||||||
| Practice Location | |||||||||
| Address1: | 1049 SE CITY BEACH ST | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982775703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606757678 | ||||||||
| FaxNumber: | 3602790614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP30005658 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.