Healthcare Provider Details

I. General information

NPI: 1669707824
Provider Name (Legal Business Name): JILL GRAF MS, ACNP-BC, CCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9003 E SHEA BLVD 2F2 SURGICAL ONCOLOGY
SCOTTSDALE AZ
85260-6709
US

IV. Provider business mailing address

9003 E SHEA BLVD 2F2 SURGICAL ONCOLOGY
SCOTTSDALE AZ
85260-6709
US

V. Phone/Fax

Practice location:
  • Phone: 410-903-2800
  • Fax:
Mailing address:
  • Phone: 480-323-4660
  • Fax: 480-323-4313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704453390
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberLP-0010840
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP4032
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: