Healthcare Provider Details

I. General information

NPI: 1073776019
Provider Name (Legal Business Name): DEBRA MCGRAW MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

414 HOOKE ST
LIBERTY MO
64068-2705
US

V. Phone/Fax

Practice location:
  • Phone: 816-802-1277
  • Fax: 816-855-1919
Mailing address:
  • Phone: 816-792-8888
  • Fax: 816-855-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2005015109
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number1275
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: