Provider Demographics
NPI:1437781408
Name:GRAEFF, JENNA DANYEL
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:DANYEL
Last Name:GRAEFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-5234
Mailing Address - Country:US
Mailing Address - Phone:717-333-7593
Mailing Address - Fax:
Practice Address - Street 1:40 DILWORTH RD
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551
Practice Address - Country:US
Practice Address - Phone:717-871-7161
Practice Address - Fax:717-871-7941
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program