Provider Demographics
NPI:1417304809
Name:GRAAF, SHARON M (PMHNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:GRAAF
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WINTER HARVEST DR
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702-8258
Mailing Address - Country:US
Mailing Address - Phone:570-954-1200
Mailing Address - Fax:
Practice Address - Street 1:10 BUIST RD STE 304
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-9311
Practice Address - Country:US
Practice Address - Phone:888-918-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015309363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY742746-01OtherREGISTERED PROFESSIONAL NURSE
NYF402333-01OtherNURSE PRACTITIONER IN PSYCHIATRY
NY742746-01OtherREGISTERED PROFESSIONAL NURSE