Provider Demographics
NPI:1437381290
Name:GRAPP, SHELLI L (ARNP)
Entity Type:Individual
Prefix:
First Name:SHELLI
Middle Name:L
Last Name:GRAPP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 7TH ST SE
Mailing Address - Street 2:MEDICAL STAFF OFFICE
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2112
Mailing Address - Country:US
Mailing Address - Phone:319-423-7200
Mailing Address - Fax:319-247-0011
Practice Address - Street 1:600 7TH ST SE
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2112
Practice Address - Country:US
Practice Address - Phone:319-423-7200
Practice Address - Fax:319-247-0011
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-098544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner