Provider Demographics
NPI:1053037341
Name:GRAVES, SHELBY (DNP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 VETERANS DR STE 107
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2168
Mailing Address - Country:US
Mailing Address - Phone:256-776-7765
Mailing Address - Fax:256-964-9567
Practice Address - Street 1:201 VETERANS DR STE 107
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2168
Practice Address - Country:US
Practice Address - Phone:256-776-7765
Practice Address - Fax:256-964-9567
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-192674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily