Provider Demographics
NPI:1053950428
Name:DEGRAFFENRIED, WENDY (RN, HN-BC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:DEGRAFFENRIED
Suffix:
Gender:F
Credentials:RN, HN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W INTERNATIONAL AIRPORT RD STE 17
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1168
Mailing Address - Country:US
Mailing Address - Phone:907-770-3656
Mailing Address - Fax:
Practice Address - Street 1:401 W INTERNATIONAL AIRPORT RD STE 17
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1168
Practice Address - Country:US
Practice Address - Phone:907-770-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK25807163W00000X, 163WA0400X, 163WC1600X, 163WD0400X, 163WW0101X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory