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NPI Code Detail

MEDICARE: MELISSA ANN GRAVES FNP

MEDICARE: MELISSA ANN GRAVES FNP
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
1363LF0000XFamily Nurse Practitioner13614TN

General Provider Information

NPI Number : 1235375494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN GRAVES FNP
Provider Business Mailing Address
First Line : 1110 VILLAGE DR
Second Line :
City : SEVIERVILLE
State : TN
Zip : 37862-5028
Country : US
Telephone Number : 865-429-8800
Fax Number : 865-429-4310
Provider Business Practice Location Address
First Line : 1110 VILLAGE DR
Second Line :
City : SEVIERVILLE
State : TN
Zip : 37862-5028
Country : US
Telephone Number : 865-429-8800
Fax Number : 865-429-4310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2008
Last Update Date : 03/02/2016

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