MEDICARE: CARRIE GRAVES NP

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
1	163WR0006X	Registered Nurse First Assistant	28156443A	IN
2	363LF0000X	Family Nurse Practitioner	71005978A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01588221	OTHER	IN	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1376975854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE GRAVES NP

Provider Business Mailing Address
First Line	:	1550 E COUNTY LINE RD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-0990
Country	:	US
Telephone Number	:	317-497-2130
Fax Number	:	317-863-2198

Provider Business Practice Location Address
First Line	:	1550 E COUNTY LINE RD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-0990
Country	:	US
Telephone Number	:	317-497-2130
Fax Number	:	317-863-2198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	02/02/2026

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Directions to “ CARRIE GRAVES NP” Practice Location

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