Individual
CHERRY ELIZABETH GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, WHNP-BC
Contact information
Practice address
14231 SEAWAY RD, SUITE 3004, GULFPORT, MS 39503-4628
(228) 206-1905
(228) 206-1917
Mailing address
14231 SEAWAY RD, SUITE 3004, GULFPORT, MS 39503-4628
(228) 206-1905
(228) 206-1917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R866332
MS
363LW0102X
Women's Health Nurse Practitioner
Primary
R866332
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12195088
CAQH ID
MS
01
—
R866332
NP LICENSE NUMBER
MS
Enumeration date
05/22/2007
Last updated
02/03/2016
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