Provider Demographics
NPI:1093055774
Name:GARRAFA, JOHANNA
Entity type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:
Last Name:GARRAFA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:GARRAFA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN
Mailing Address - Street 1:HC 64 BOX 8417
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HC 64 BOX 8417
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-9720
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:787-866-8861
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse