Individual
DANIEL W. GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6119 MIDTOWN AVE, SUITE 201, LITTLE ROCK, AR 72205-5313
(501) 664-4532
(501) 663-4335
Mailing address
6119 MIDTOWN AVE, SUITE 201, LITTLE ROCK, AR 72205-5313
(501) 664-4532
(501) 663-4335
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R079737
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C002679
AR
367500000X
Certified Registered Nurse Anesthetist
RN133006
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520384
—
TN
01
—
4255510
BCBS
TN
Enumeration date
12/08/2005
Last updated
06/16/2015
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