Provider Demographics
NPI:1184207870
Name:LAGRAFF, CHRISTOPHER LEWIS
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEWIS
Last Name:LAGRAFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7595 PRAIRIE CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-5215
Mailing Address - Country:US
Mailing Address - Phone:517-672-2075
Mailing Address - Fax:
Practice Address - Street 1:7595 PRAIRIE CT
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-5215
Practice Address - Country:US
Practice Address - Phone:517-672-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704342620367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered