Provider Demographics
NPI:1720300189
Name:NOFSINGER, DEGRA DUANE (CPM, LM)
Entity Type:Individual
Prefix:MS
First Name:DEGRA
Middle Name:DUANE
Last Name:NOFSINGER
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 MONTVALE RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-4124
Mailing Address - Country:US
Mailing Address - Phone:540-312-0099
Mailing Address - Fax:
Practice Address - Street 1:2426 MONTVALE RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-4124
Practice Address - Country:US
Practice Address - Phone:540-312-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000051176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife