Provider Demographics
NPI:1609425453
Name:GRAP, CHRISTINE CAROL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CAROL
Last Name:GRAP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9106 PHILADELPHIA RD STE 304
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4343
Mailing Address - Country:US
Mailing Address - Phone:410-382-2975
Mailing Address - Fax:
Practice Address - Street 1:9106 PHILADELPHIA RD STE 304
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4343
Practice Address - Country:US
Practice Address - Phone:410-238-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR106077363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner