Healthcare Provider Details

I. General information

NPI: 1083203954
Provider Name (Legal Business Name): LAURA GRAZE DNP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 SE OCEAN BLVD STE 2
STUART FL
34994-2400
US

IV. Provider business mailing address

528 SE OSCEOLA ST STE 1B
STUART FL
34994-2366
US

V. Phone/Fax

Practice location:
  • Phone: 772-800-9796
  • Fax:
Mailing address:
  • Phone: 772-800-9796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA GRAZE
Title or Position: NURSE PRACTITIONER/OWNER
Credential: APRN
Phone: 772-800-9796