Healthcare Provider Details

I. General information

NPI: 1326961236
Provider Name (Legal Business Name): KARSON JAY GRAVES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 APACHE DR
JONESBORO AR
72401-7404
US

IV. Provider business mailing address

7400 DEERWOOD DR
PARAGOULD AR
72450-6209
US

V. Phone/Fax

Practice location:
  • Phone: 870-333-5437
  • Fax:
Mailing address:
  • Phone: 870-573-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number235710
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: