Provider Demographics
NPI:1891670196
Name:GRAFF, TINA M
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:GRAFF
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:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:ALDA
Mailing Address - State:NE
Mailing Address - Zip Code:68810-0263
Mailing Address - Country:US
Mailing Address - Phone:308-383-2751
Mailing Address - Fax:
Practice Address - Street 1:1003 LILLY ST
Practice Address - Street 2:
Practice Address - City:WOOD RIVER
Practice Address - State:NE
Practice Address - Zip Code:68883-2107
Practice Address - Country:US
Practice Address - Phone:308-583-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant