Provider Demographics
NPI:1235243452
Name:GRAFF, NANCY B (RD, MPH)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:B
Last Name:GRAFF
Suffix:
Gender:F
Credentials:RD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5998
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-5998
Mailing Address - Country:US
Mailing Address - Phone:340-719-9644
Mailing Address - Fax:340-719-9641
Practice Address - Street 1:SUNNY ISLE PROFESSIONAL BLDG SUITE 6F
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00823
Practice Address - Country:US
Practice Address - Phone:340-626-7576
Practice Address - Fax:340-719-9641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIR611109133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI6-2732BMedicare ID - Type UnspecifiedPROVIDER NUMBER