Provider Demographics
NPI:1528157351
Name:GRAFFIUS, ROSEMARY JEAN (ANP)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:JEAN
Last Name:GRAFFIUS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 TUDOR CENTRE DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5904
Mailing Address - Country:US
Mailing Address - Phone:907-729-8624
Mailing Address - Fax:907-729-8607
Practice Address - Street 1:101 TAKOTNA AVE
Practice Address - Street 2:
Practice Address - City:MCGRATH
Practice Address - State:AK
Practice Address - Zip Code:99627-9800
Practice Address - Country:US
Practice Address - Phone:907-729-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008959363LF0000X
AK635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP0037Medicaid
AKNP0037Medicaid
AK8EL870Medicare PIN
AK8EL871Medicare PIN