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NPI Code Detail

MEDICARE: MRS. NATASHA B GRAVES APRN, FNP-BC

MEDICARE: MRS. NATASHA B GRAVES APRN, FNP-BC
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 Practitioner224980LA

General Provider Information

NPI Number : 1487393039
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NATASHA B GRAVES APRN, FNP-BC
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-765-5500
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 1024 E ASCENSION COMPLEX BLVD
Second Line :
City : GONZALES
State : LA
Zip : 70737-4263
Country : US
Telephone Number : 225-765-5500
Fax Number : 225-644-2822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2022
Last Update Date : 09/28/2023

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