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1801559984
LISA MAE DIANE GRAVELINE
PRESCOTT VALLEY, AZ
NPI
1801559984
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AZ RNP265685)
Enumeration Date
2021-10-15
Last Update Date
2024-03-13
Business Address
LISA MAE DIANE GRAVELINE PMHNP-BC, APRN-RNP
3274 BOB DR
PRESCOTT VALLEY, AZ 86314-8640
Phone number: 928-203-5414
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Mailing Address
LISA MAE DIANE GRAVELINE PMHNP-BC, APRN-RNP
3274 BOB DR
PRESCOTT VALLEY, AZ 86314-8640
Phone number: 928-203-5414
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