Provider Demographics
NPI:1912335100
Name:GRAW, KIMBERLY H (APRN, BC, FNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:H
Last Name:GRAW
Suffix:
Gender:F
Credentials:APRN, BC, FNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:HOPE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:130 N GROSS ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548
Mailing Address - Country:US
Mailing Address - Phone:912-729-2795
Mailing Address - Fax:912-729-4117
Practice Address - Street 1:130 N GROSS ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548
Practice Address - Country:US
Practice Address - Phone:912-729-2795
Practice Address - Fax:912-729-4117
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily