Individual
DR. KATHLEEN L. GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3850 S NATIONAL AVE, #400, SPRINGFIELD, MO 65807-5287
(417) 269-6850
(417) 269-5830
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R6E59
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202105904
—
MO
01
—
5950
BLUE CROSS MO
—
Enumeration date
09/20/2006
Last updated
07/15/2019
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