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NPI Code Detail

MEDICARE: TRACY GRAFTON

MEDICARE: TRACY GRAFTON
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
1363LF0000XFamily Nurse Practitioner96484KS

General Provider Information

NPI Number : 1790227817
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY GRAFTON
Provider Business Mailing Address
First Line : 537 S FREEBORN ST
Second Line :
City : MARION
State : KS
Zip : 66861-1243
Country : US
Telephone Number : 620-382-2033
Fax Number :
Provider Business Practice Location Address
First Line : 537 S FREEBORN ST
Second Line :
City : MARION
State : KS
Zip : 66861-1243
Country : US
Telephone Number : 620-382-2033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2016
Last Update Date : 11/07/2016

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Directions to “ TRACY GRAFTON ” Practice Location

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