Individual
DENISE MARIE GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(610) 954-5810
(610) 954-5480
Mailing address
PO BOX 5520, BETHLEHEM, PA 18015-0520
(610) 954-5810
(610) 954-5480
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN354580L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
072988
PA
367500000X
Certified Registered Nurse Anesthetist
RN354580L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027806650001
—
PA
01
—
11803021
CAQH
PA
01
—
1584019
GATEWAY
PA
01
—
1675564
FIRST PRIORITY
PA
01
—
2001184
KHP CENTRAL
PA
01
—
2350206000
INDEP. BLUE CROSS
PA
01
—
50044074
CAPITAL ADVANTAGE
PA
01
—
90778
GEISINGER
PA
01
—
9204472
AETNA
PA
Enumeration date
09/19/2005
Last updated
01/31/2023
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