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General NPI Number Information
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NPI Number | 1679921779
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Entity Type | Individual
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Provider Name | KELSEY R GRAVEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2016
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 4600 LAKE BOONE TR SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27607
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Country | US
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Telephone | 197-871-3749
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Fax | 919-571-8135
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Provider Business Mailing Address
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Address Line | 4600 LAKE BOONE TR SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27607
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Country | US
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Telephone | 919-787-1374
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Fax | 919-571-8135
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 202101872
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License Number State | NC
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