Provider Demographics
NPI:1356650998
Name:DEGRAFF, PAM (CD(DONA))
Entity Type:Individual
Prefix:
First Name:PAM
Middle Name:
Last Name:DEGRAFF
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17339 N 64TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4500
Mailing Address - Country:US
Mailing Address - Phone:602-291-5336
Mailing Address - Fax:
Practice Address - Street 1:17339 N 64TH LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-4500
Practice Address - Country:US
Practice Address - Phone:602-291-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula