MEDICARE: MRS. HEIDI ROSEMARIE GRAF 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	363LF0000X	Family Nurse Practitioner	AP30005658	WA

General Provider Information

NPI Number	:	1376543397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEIDI ROSEMARIE GRAF ARNP

Provider Business Mailing Address
First Line	:	1620 NORTHWEST OUTRIGGER LOOP
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-0000
Country	:	US
Telephone Number	:	360-675-9528
Fax Number	:	360-675-9369

Provider Business Practice Location Address
First Line	:	1049 SE CITY BEACH ST
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-5703
Country	:	US
Telephone Number	:	360-675-7678
Fax Number	:	360-279-0614

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

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	07/08/2007

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