Provider Demographics
NPI:1023045952
Name:MCGRAW, DEBRA L (CFNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 HARPER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3375
Mailing Address - Country:US
Mailing Address - Phone:304-252-9211
Mailing Address - Fax:304-252-9218
Practice Address - Street 1:1802 HARPER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3375
Practice Address - Country:US
Practice Address - Phone:304-252-9211
Practice Address - Fax:304-252-9218
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41174363LF0000X
OHNP.11195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH291672OtherUNISON
WV7103041000Medicaid
WV1057716OtherBWC
OH310917086051OtherCARESOURCE
OH291672OtherUNISON
WV513410Medicare Oscar/Certification
WV7103041000Medicaid