Individual
MISS DEIDRE A GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2159 MELROSE AVE, COLUMBUS, OH 43224-2448
(614) 537-6358
Mailing address
2159 MELROSE AVE, COLUMBUS, OH 43224-2448
(614) 537-6358
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
135201
OH
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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