Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN11007044 | FL |
NPI | 1003425232 |
---|---|
Provider Name | Sara Elizabeth Graves |
First Address | Tampa, FL 33603-1433 |
Second Address | Tampa, FL 33603-1433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2020 |
Last Update Date | 23/07/2020 |