| Shellie Dean Graves, NP | |
|
520 S Eagle Rd Ste 2213, Meridian, ID 83642-6354 | |
| (208) 706-5447 | |
| (208) 706-5448 |
| Full Name | Shellie Dean Graves |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Occupational Health |
| Location | 520 S Eagle Rd Ste 2213, Meridian, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043869738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | NP95011932 (California) | Secondary |
| 363LX0106X | Nurse Practitioner - Occupational Health | 2271947 (Idaho) | Primary |
| Entity Name | St Lukes Clinic-treasure Valley LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Shellie Dean Graves, NP 190 E Bannock St, Boise, ID 83712-6241 Ph: Not Available | Shellie Dean Graves, NP 520 S Eagle Rd Ste 2213, Meridian, ID 83642-6354 Ph: (208) 706-5447 |
Jennifer Lytle, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1526 W Ustick Rd Ste 110, Meridian, ID 83646 Phone: 208-370-5888 |
Rachael Marie Knuteson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1948 S Eagle Rd, Meridian, ID 83642 Phone: 208-322-7900 |
Heidi Ann Fanslow, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6830 N Agrarian Ave, Meridian, ID 83646 Phone: 253-951-8331 |
Jessica Rose Johnson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3520 E Louise Dr, Meridian, ID 83642 Phone: 208-888-0909 Fax: 208-888-5825 |
Josef Mcguire, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3080 E Gentry Way Ste 210, Meridian, ID 83642 Phone: 208-384-9022 |
Michael Pahang, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1550 N Crestmont Dr, Meridian, ID 83642 Phone: 208-288-4200 Fax: 208-288-4279 |
Sarah Cheree Johnson, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3653 N Locust Grove Rd, Meridian, ID 83646 Phone: 208-302-7300 Fax: 208-302-7355 |