Provider Demographics
NPI:1164583852
Name:GRAZULIS, MICHELE MCGOWAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:MCGOWAN
Last Name:GRAZULIS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-6425
Mailing Address - Fax:559-353-6441
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6425
Practice Address - Fax:559-353-6441
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-11-08
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Provider Licenses
StateLicense IDTaxonomies
CA583830363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics