Individual
MICHELLE LYNN GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
24760 HOSPITAL RD, RED LAKE, MN 56671
(218) 679-3912
Mailing address
PO BOX 695, REDBY, MN 56670-0695
(218) 766-5124
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10703
MN
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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