Individual
ALYCIA VALERIE GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1500 N RITTER AVE, INDIANAPOLIS, IN 46219-3027
(317) 355-5486
Mailing address
1500 N RITTER AVE, INDIANAPOLIS, IN 46219-3027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28160509A
IN
363LF0000X
Family Nurse Practitioner
Primary
71015046A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300087792
—
IN
Enumeration date
11/02/2023
Last updated
04/15/2024
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