Individual
ALEXIS RENEE GRAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 N EDWARD ST STE 2400, DECATUR, IL 62526-4163
(217) 876-2400
Mailing address
2300 N EDWARD ST STE 2400, DECATUR, IL 62526-4163
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016875
IL
Other
Enumeration date
11/08/2017
Last updated
07/15/2022
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