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General NPI Number Information
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NPI Number | 1861104168
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Entity Type | Individual
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Provider Name | KATHERYN ELIZABETH GRAVES
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Gender | Female
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 5555 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-4622
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Country | US
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Telephone | 720-394-0137
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Fax |
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Provider Business Mailing Address
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Address Line | 11546 MARSHALL ST
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City | WESTMINSTER
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State | CO
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Zip | 80020-3036
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Country | US
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Telephone | 720-394-0137
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 296937
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | RN.1657588
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License Number State | CO
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