Provider Demographics
NPI:1588087571
Name:GRAZE, LAURA (DNP)
Entity type:Individual
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First Name:LAURA
Middle Name:
Last Name:GRAZE
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:600 NE BAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-6824
Mailing Address - Country:US
Mailing Address - Phone:772-800-9796
Mailing Address - Fax:772-521-9937
Practice Address - Street 1:528 SE OSCEOLA ST STE 1B
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2366
Practice Address - Country:US
Practice Address - Phone:772-241-7880
Practice Address - Fax:772-403-9042
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2024-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9377327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103595300Medicaid