| Doctor Name: | HOLLY DAWN GRAVES |
| NPI Number: | 1083085898 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 53-76970-122 |
| Business Practice Address: | 1101 N Rock Rd Derby, KS - 670373705 |
| Business Phone Number: | 3167886963 |
| Business Fax Number: | 3167885373 |
| Mailing Address: | 1101 N Rock Rd, DERBY |
| State: | KS |
| Postal Code: | 670373705 |
| Phone Number: | 3167886963 |
| Fax Number: | 3167885373 |
| NPI Enumeration Date: | 10/19/2015 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 53-76970-122 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |