| Doctor Name: | STACI MARIE GRABER |
| NPI Number: | 1154538247 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | R68831 |
| Business Practice Address: | 5203 Willow Creek Dr Johnson, AR - 72741 |
| Business Phone Number: | 4797578001 |
| Business Fax Number: | 4797500571 |
| Mailing Address: | 5501 Willow Creek Dr, SPRINGDALE |
| State: | AR |
| Postal Code: | 727628704 |
| Phone Number: | 4795759359 |
| Fax Number: | 4795759415 |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 02/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R68831 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |