NPI | 1083313761 |
---|---|
Former Name | MISTY GRAVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 289235) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: AZ RN151875) |
202D00000X Integrative Medicine (Licence: AZ 289235) | |
207Q00000X Family Medicine (Licence: AZ 289235) | |
Enumeration Date | 2023-03-01 |
Last Update Date | 2024-08-20 |