Mary Jo Graves, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

C236057-NPF 361 Issued in CA

Practice address

7011 N Howard St Ste 202
Fresno, CA 93720-2955

Phone

(559) 438-4100

Fax

(559) 447-4496

NPI assigned

Feb 16, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1962861179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 N HOWARD ST STE 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202955",
            "telephone_number": "559-438-4100",
            "fax_number": "559-447-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 N HOWARD ST STE 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202955",
            "telephone_number": "559-438-4100",
            "fax_number": "559-447-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "C236057-NPF 361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert C Grasso, LCSW
• Jason Gravano, PH.D.
• Yvonne Gravelle
• Drew Graves
• Hailey Jayde Graves
• Tracy Graves
• Zeb Kerrenthius Graves III
• Susan Kristeen Gravette, LMFT
• Madison Paige Graville
• Andrew Anthony Gray

• Pediatric Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.