Provider Demographics
NPI:1295337905
Name:GRABER, MERCEDES LYNN
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:LYNN
Last Name:GRABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERCEDES
Other - Middle Name:LYNN
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1894 NESTORVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-7403
Mailing Address - Country:US
Mailing Address - Phone:304-669-2836
Mailing Address - Fax:
Practice Address - Street 1:1894 NESTORVILLE RD
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-7403
Practice Address - Country:US
Practice Address - Phone:304-669-2836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant