Provider Demographics
NPI:1386773968
Name:GRAFFORD, CAROL A (RD, CDE)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:GRAFFORD
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1532
Mailing Address - Country:US
Mailing Address - Phone:906-487-6997
Mailing Address - Fax:
Practice Address - Street 1:500 CAMPUS DR
Practice Address - Street 2:DIABETES EDUCATION
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1569
Practice Address - Country:US
Practice Address - Phone:906-483-1562
Practice Address - Fax:906-483-1149
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
819518OtherREGISTERED DIETITIAN
2022-0200OtherCERTIF. DIABETES EDUCATOR
MICG819518OtherBLUECROSS STATE ID
2022-0200OtherCERTIF. DIABETES EDUCATOR