SHELLIE DEAN GRAVES


Address: 15 Albergar, San Clemente, CA 92672-9403
Phone: 7145992196

SHELLIE DEAN GRAVES (NPI# 1043869738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043869738
Entity Type Individual
Full Name SHELLIE DEAN GRAVES
Credential NP
Practice Address 15 Albergar
San Clemente
CA 92672-9403
Practice Telephone 7145992196
Mailing Telephone 7145992196
Enumeration Date 2019-09-05
Last Update Date 2019-09-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
NP95011932 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 15 ALBERGAR
City SAN CLEMENTE
State CA
Zip Code 92672-9403

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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City SAN CLEMENTE
Zip Code 92672

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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