Provider Demographics
NPI:1497530190
Name:BRAUCHT, GRAYCEN MARALEE (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:GRAYCEN
Middle Name:MARALEE
Last Name:BRAUCHT
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 E FRANKLIN ST APT 215
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7006
Mailing Address - Country:US
Mailing Address - Phone:703-357-3784
Mailing Address - Fax:
Practice Address - Street 1:2201 E FRANKLIN ST APT 215
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7006
Practice Address - Country:US
Practice Address - Phone:703-357-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230032574183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician