Deanna Graves
Individual provider Active NPI Contractor · Raleigh, NC
NPI 1497167100 · NPPES record last updated May 29, 2014
Key facts
- NPI
- 1497167100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- LBMT 6782 (NC)
- Practice address
- 700 Exposition PL Ste 171
Raleigh, NC 27615-1563 - Phone
- (919) 601-4328
- NPI assigned
- May 29, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LBMT 6782 | NC | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | LBMT 6782 | NC | Yes |
Addresses
Primary practice location
700 Exposition PL Ste 171
Raleigh, NC 27615-1563
Mailing address
700 Exposition PL Ste 171
Raleigh, NC 27615-1563
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.