Individual
JONATHAN C GRABER
Active
Individual
JONATHAN C GRABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
28113375A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000256A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000531843
ANTHEM PIN
—
05
—
200125900
—
IN
01
—
P00090584
RAILROAD MEDICARE PIN
IN
Enumeration date
06/15/2006
Last updated
11/07/2007
Update your record
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