Provider Demographics
NPI:1427667989
Name:GRAVES, EMILY (PHARMD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 MCGEE COVE RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-8802
Mailing Address - Country:US
Mailing Address - Phone:770-490-2128
Mailing Address - Fax:
Practice Address - Street 1:357 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2519
Practice Address - Country:US
Practice Address - Phone:770-490-2128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist