Provider Demographics
NPI:1790090827
Name:GRAEF, JULIE MAREE
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MAREE
Last Name:GRAEF
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 1:201 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LENA
Mailing Address - State:WI
Mailing Address - Zip Code:54139-9264
Mailing Address - Country:US
Mailing Address - Phone:920-373-1939
Mailing Address - Fax:
Practice Address - Street 1:201 4TH ST
Practice Address - Street 2:
Practice Address - City:LENA
Practice Address - State:WI
Practice Address - Zip Code:54139-9264
Practice Address - Country:US
Practice Address - Phone:920-373-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI170177-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health