Mianne Graa, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN17279 Issued in MT

Practice address

401 S Washington St
Butte, MT 59701-2423

Phone

(406) 723-8051

Fax

(406) 723-8063

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mianne Jenrich Professional name

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercury Street Medical Group PLLC

  • Physician Assistant
  • Butte, MT
  • NPI 1619054681
  NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497783062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597017102",
            "telephone_number": "406-723-8051",
            "fax_number": "406-723-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S WASHINGTON ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012423",
            "telephone_number": "406-723-8051",
            "fax_number": "406-723-8063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 S Alabama St",
            "address_purpose": "LOCATION",
            "city": "Butte",
            "state": "MT",
            "postal_code": "597012315",
            "country_code": "US",
            "telephone_number": "406-723-8051",
            "fax_number": "406-723-8063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAA",
        "first_name": "MIANNE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MT",
            "license": "RN17279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430695",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37023",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIANNE",
            "last_name": "JENRICH",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alina Lee Gonzales, LMT
• Dale Good Gun
• Dawn Gordon-Wilcox, IBCLC
• Kayla Gordon, PA-C
• Deborah Jean Gorman, ESTHETCIAN,
• Wendy Terese Grace, MD
• Beverley Gransbery, MS, PT
• Greenwood Assisted Living
• Delanie Greer, DPT
• Jordan Hugart Greer, DO

• Women's Health Nurse Practitioner in Butte, MT
• Providers in Butte, MT by specialty
• Women's Health Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.