Provider Demographics
NPI:1497139067
Name:DIGMAN, GRACE ANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:ANN
Last Name:DIGMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ANN
Other - Last Name:BRECKENRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 W HINDS AVE
Mailing Address - Street 2:
Mailing Address - City:SHERRILL
Mailing Address - State:NY
Mailing Address - Zip Code:13461-1150
Mailing Address - Country:US
Mailing Address - Phone:315-761-7150
Mailing Address - Fax:
Practice Address - Street 1:1055 MADISON MARKETPLACE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-2343
Practice Address - Country:US
Practice Address - Phone:315-825-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339880-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily