Individual
MS. LISA D GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2405 OSLER CT, ALBANY, GA 31707-0214
(229) 435-1458
(229) 317-2342
Mailing address
2405 OSLER CT, ALBANY, GA 31707-0214
(229) 435-1458
(229) 317-2342
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN137513 NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000782779F
—
GA
Enumeration date
09/21/2006
Last updated
01/05/2010
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