Provider Demographics
NPI:1912568171
Name:GRAVES, DANIELE D (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANIELE
Middle Name:D
Last Name:GRAVES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 GANEGA TRL
Mailing Address - Street 2:
Mailing Address - City:VONORE
Mailing Address - State:TN
Mailing Address - Zip Code:37885-2656
Mailing Address - Country:US
Mailing Address - Phone:423-295-4320
Mailing Address - Fax:
Practice Address - Street 1:249 GANEGA TRL
Practice Address - Street 2:
Practice Address - City:VONORE
Practice Address - State:TN
Practice Address - Zip Code:37885-2656
Practice Address - Country:US
Practice Address - Phone:865-924-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily