Mary Jean Degrave, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704236417 Issued in MI

Practice address

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637

Phone

(906) 774-1313

NPI assigned

Oct 17, 2014

Last updated

Oct 17, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1255735494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E21892 CROOKED LAKE RD",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499699740",
            "telephone_number": "906-285-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAVE",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704236417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Davis
• Katherine M Day
• Marie Grace De Guzman
• Tracy Debidart, BSN, RN
• Teri Lynn Degrand, PSY.D.
• Michelle Degrave
• Theresa Degroot
• Maria Michelle Demerse, RDH
• Anna Demeuse, RN
• Shelby Marie Demeuse

• Family Nurse Practitioner in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.