Basic Information
Provider Information
NPI: 1669021556
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRAFF-HARRISON
FirstName: SHARON
MiddleName: MOINET
NamePrefix:  
NameSuffix:  
Credential: RD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ACKERMAN RD STE 2120
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021559
CountryCode: US
TelephoneNumber: 6142938000
FaxNumber:  
Practice Location
Address1: 410 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6146853333
FaxNumber: 6143660345
Other Information
ProviderEnumerationDate: 09/04/2019
LastUpdateDate: 02/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X3360OHY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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