Individual
KENYETTA D. GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8700 BEVERLY BLVD # SB290, WEST HOLLYWOOD, CA 90048-1804
(310) 423-1447
(310) 423-0987
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
(310) 423-1447
(310) 423-0987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
209009328
IL
367500000X
Certified Registered Nurse Anesthetist
209.009328
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
95002032
CA
Other
Enumeration date
03/14/2012
Last updated
11/08/2023
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