Provider Demographics
NPI:1598057705
Name:GREAVES, YVETTE DOLORES (NP-C)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:DOLORES
Last Name:GREAVES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 BELTLINE RD SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3617
Mailing Address - Country:US
Mailing Address - Phone:256-973-4033
Mailing Address - Fax:256-973-4135
Practice Address - Street 1:2205 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3617
Practice Address - Country:US
Practice Address - Phone:256-973-4033
Practice Address - Fax:256-973-4135
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-059911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty