Healthcare Provider Details

I. General information

NPI: 1851301626
Provider Name (Legal Business Name): WENDY ANN GRAEFE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 GREENBRIER PKWY STE B
CHESAPEAKE VA
23320-3823
US

IV. Provider business mailing address

1326 MARION ST
NORFOLK VA
23505-3028
US

V. Phone/Fax

Practice location:
  • Phone: 757-548-2800
  • Fax: 757-548-9581
Mailing address:
  • Phone: 757-739-9239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024166287
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: