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General NPI Number Information
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NPI Number | 1053847970
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Entity Type | Individual
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Provider Name | COURTNEY GRAVES R.N.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 2118 ACKLEN AVE APT 6
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City | NASHVILLE
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State | TN
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Zip | 37212-3531
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Country | US
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Telephone | 512-924-6228
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 ACKLEN AVE APT 6
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City | NASHVILLE
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State | TN
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Zip | 37212-3531
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Country | US
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Telephone | 512-924-6228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23590
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0000210200
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License Number State | TN
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