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NPI Code Detail

MEDICARE: MRS. VALORIE JEAN GRAVES PA

MEDICARE:  MRS. VALORIE JEAN GRAVES  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant374OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144277351
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VALORIE JEAN GRAVES PA
Provider Business Mailing Address
First Line : 4401 W MEMORIAL RD
Second Line : SUITE 140
City : OKLAHOMA CITY
State : OK
Zip : 73134-1785
Country : US
Telephone Number : 405-752-3162
Fax Number : 405-936-5211
Provider Business Practice Location Address
First Line : 2001 PARKVIEW DR
Second Line :
City : EL RENO
State : OK
Zip : 73036-2107
Country : US
Telephone Number : 405-262-2114
Fax Number : 405-262-2306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 05/20/2014

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Directions to “ MRS. VALORIE JEAN GRAVES PA” Practice Location

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