Jennifer Gravenish, ARNP
Nurse Practitioner, Psych/Mental Health in Emmetsburg, IA. Individual provider (NPI-1).
NPI number1164093399
StatusActive
Last updated in NPPESDec 20, 2022
Details
- NPI
- 1164093399
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Gravenish
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2021
- Certification date
- Dec 20, 2022
- Last updated
- Dec 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | G166054 | IA | Yes |
| 163W00000X | Registered Nurse | 141312 | IA |
Practice location
3201 1st StEmmetsburg, IA 50536-2516
Phone 712-221-0684
Mailing address
930 W Bluff StCherokee, IA 51012-1531
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