Healthcare Provider Details

I. General information

NPI: 1013307685
Provider Name (Legal Business Name): CHRISTA ELANE DEGRAZIA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 CLEAR CREEK DR SUITE 350
ASHLAND OR
97520-1851
US

IV. Provider business mailing address

146 CLEAR CREEK DR
ASHLAND OR
97520-1851
US

V. Phone/Fax

Practice location:
  • Phone: 541-494-8888
  • Fax: 541-494-1300
Mailing address:
  • Phone: 541-494-8888
  • Fax: 541-494-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201500652NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: