Individual
LINDA KELLY GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
625 CLARK AVE STE 17B, KING OF PRUSSIA, PA 19406-1438
(215) 654-1544
(215) 654-1543
Mailing address
PO BOX 13869, PHILADELPHIA, PA 19101-3869
(610) 340-3530
(610) 337-0185
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
RN225600L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN225600L
LICENSE
PA
Enumeration date
05/23/2019
Last updated
05/23/2019
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