Provider Demographics
NPI:1619506326
Name:GRAEFF, SHELBY ERIN (PA-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:ERIN
Last Name:GRAEFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:ERIN
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1310 MERGANSER LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-7822
Mailing Address - Country:US
Mailing Address - Phone:570-573-5120
Mailing Address - Fax:
Practice Address - Street 1:2106 HARRISBURG PIKE STE 322
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-5945
Practice Address - Fax:717-544-5944
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-04
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061697363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant