Individual
DR. NANCY JANE GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3102 GOLANSKY BLVD, STE 101, WOODBRIDGE, VA 22192-4244
(703) 590-2888
(703) 590-1121
Mailing address
3102 GOLANSKY BLVD, STE 101, WOODBRIDGE, VA 22192-4244
(703) 590-2888
(703) 590-1121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000496
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0937760001
MEDICARE SUPPLIER NUMBER
VA
01
—
1477731172
PRACTICE NPI
VA
Enumeration date
06/09/2005
Last updated
11/30/2012
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