Provider Demographics
NPI:1144393927
Name:GRAVES, MARION
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:
Last Name:GRAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 AUGUSTA BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8627
Mailing Address - Country:US
Mailing Address - Phone:513-227-0722
Mailing Address - Fax:
Practice Address - Street 1:2500 AUGUSTA BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-8627
Practice Address - Country:US
Practice Address - Phone:513-227-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide