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General NPI Number Information
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NPI Number | 1801611959
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Entity Type | Individual
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Provider Name | DIANA MARIE GRAVES FNP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1855 PLUMAS ST STE 5
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City | RENO
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State | NV
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Zip | 89509-3385
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Country | US
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Telephone | 775-843-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 12305 BRENTFIELD DR
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City | RENO
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State | NV
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Zip | 89511-6226
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Country | US
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Telephone | 408-472-6648
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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 | 823041
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License Number State | NV
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