Individual
TRACY JO GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1314 RILEY LN, DEXTER, MO 63841-2767
(573) 624-2324
Mailing address
1314 RILEY LN, DEXTER, MO 63841-2767
(573) 624-2324
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2011002609
MO
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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