Individual
MS. GWENDRA G GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
51434 OLD ROUTE 50, LONDONDERRY, OH 45647-8907
(740) 773-1141
Mailing address
51434 OLD ROUTE 50, LONDONDERRY, OH 45647-8907
(740) 773-1141
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
280084
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2022
Last updated
06/09/2022
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