Individual
DR. YONIQUE PETRECE PETGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
51 N DUNLAP ST STE 400, MEMPHIS, TN 38105-4625
(901) 287-7337
Mailing address
850 POPLAR AVE BLDG 2, MEMPHIS, TN 38105-4607
(901) 287-8693
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
60407
TN
390200000X
Student in an Organized Health Care Education/Training Program
19723
FL
Other
Enumeration date
07/02/2014
Last updated
07/31/2020
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