Provider Demographics
NPI:1548744378
Name:GRAVES, FLESHIA PATCHES
Entity Type:Individual
Prefix:
First Name:FLESHIA
Middle Name:PATCHES
Last Name:GRAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLESHIA
Other - Middle Name:PATCHES
Other - Last Name:WHALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5654
Mailing Address - Country:US
Mailing Address - Phone:423-317-9344
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:880 RUTLEDGE PIKE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:TN
Practice Address - Zip Code:37709-2317
Practice Address - Country:US
Practice Address - Phone:865-933-4110
Practice Address - Fax:865-933-4729
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy