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Individual

TRENT BOONE GRAVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
201 W 69TH ST, SIOUX FALLS, SD 57108-2403
(605) 336-0635
Mailing address
46213 252ND ST, HARTFORD, SD 57033-5743
(605) 261-9046

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001433
SD

Other

Enumeration date
08/31/2018
Last updated
08/31/2018
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