Provider Demographics
NPI:1891931101
Name:GRAVES, DEBORAH SUE
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUE
Last Name:GRAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13480 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-4046
Mailing Address - Country:US
Mailing Address - Phone:740-774-2300
Mailing Address - Fax:
Practice Address - Street 1:13480 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-4046
Practice Address - Country:US
Practice Address - Phone:740-774-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.097872164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse