Provider Demographics
NPI:1851276653
Name:MCGRAW, HAVEN MCKENNA DALE
Entity type:Individual
Prefix:
First Name:HAVEN
Middle Name:MCKENNA DALE
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 N BEND CT NE # 274
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-9479
Mailing Address - Country:US
Mailing Address - Phone:740-606-1143
Mailing Address - Fax:
Practice Address - Street 1:274 N BEND CT NE # 274
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-9479
Practice Address - Country:US
Practice Address - Phone:740-606-1143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide