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General NPI Number Information
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NPI Number | 1407321144
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Entity Type | Individual
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Provider Name | LORENETTA LOUISE GRAVES FNP
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Gender | Female
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Dates
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Enumeration Date | 10/09/2018
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 2955 FORT CAMPBELL BLVD
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City | HOPKINSVILLE
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State | KY
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Zip | 42240
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Country | US
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Telephone | 270-632-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 495 TURNER DR
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City | MCDONOUGH
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State | GA
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Zip | 30252-4902
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Country | US
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Telephone | 678-642-8514
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 30867
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 159299
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11010230
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3013163
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 278581
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 220788
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24884
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License Number State | TN
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