MEDICARE: LYNNETTE A GRAESING ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	A081867	IA

General Provider Information

NPI Number	:	1023080272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNETTE A GRAESING ARNP

Provider Business Mailing Address
First Line	:	24 N 9TH ST
Second Line	:	SUITE A
City	:	FORT DODGE
State	:	IA
Zip	:	50501-3909
Country	:	US
Telephone Number	:	515-574-6890
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 2ND AVE N
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-3602
Country	:	US
Telephone Number	:	515-576-2235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/27/2007

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Directions to “ LYNNETTE A GRAESING ARNP” Practice Location

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