Provider Demographics
NPI:1023398492
Name:GRAVES, TAMMIE MULLINS (CNA)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:MULLINS
Last Name:GRAVES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 COUNTY ROAD 233
Mailing Address - Street 2:
Mailing Address - City:SANDROCK
Mailing Address - State:AL
Mailing Address - Zip Code:35983-5517
Mailing Address - Country:US
Mailing Address - Phone:256-996-5069
Mailing Address - Fax:
Practice Address - Street 1:960 COUNTY ROAD 233
Practice Address - Street 2:
Practice Address - City:SANDROCK
Practice Address - State:AL
Practice Address - Zip Code:35983-5517
Practice Address - Country:US
Practice Address - Phone:256-996-5069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide