Provider Demographics
NPI:1679342752
Name:GRAVES, ZANDALEE HANNAH
Entity Type:Individual
Prefix:
First Name:ZANDALEE
Middle Name:HANNAH
Last Name:GRAVES
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 1:5948 DEAN RD SW APT 9
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-7909
Mailing Address - Country:US
Mailing Address - Phone:319-640-7867
Mailing Address - Fax:
Practice Address - Street 1:2030 1ST AVE NE APT 202
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6366
Practice Address - Country:US
Practice Address - Phone:319-640-7867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore Provider