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NPI 1790459923

NPI 1790459923 : CHRISTY D GRAVES APN : HOT SPRINGS, AR

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General NPI Number Information
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    NPI Number           |    1790459923
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTY D GRAVES APN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/02/2021
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    Last Update Date     |    08/02/2021
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Provider Practice Location Address
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    Address Line         |    1662 HIGDON FERRY RD STE 300 
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    City                 |    HOT SPRINGS
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    State                |    AR
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    Zip                  |    71913-6982
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    Country              |    US
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    Telephone            |    501-321-2663
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    Fax                  |    501-321-9705
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Provider Business Mailing Address
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    Address Line         |    PO BOX 21850 
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    City                 |    HOT SPRINGS
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    State                |    AR
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    Zip                  |    71903-1850
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    Country              |    US
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    Telephone            |    501-321-2663
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    124410
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    License Number State |    AR
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