Individual provider · Type 1 NPI
Jessica Laura Graves, PA-C
Medical Physician Assistant · Broken Arrow, OK
NPI number
1407120066
Active
Practice location
4700 W Urbana St Ste 100
Broken Arrow, OK 74012-5520
Other practice locations
- 333 S 38th St Ste E, Muskogee, OK 74401-4937 · (918) 840-5276
- 110 E Kaahumanu Ave, Kahului, HI 96732-2118 · (808) 871-1730
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA2129 (OK) |
| Physician Assistant | 363A00000X | AMD-770 (HI) |
Medical Physician Assistant: Definition to come...
Another provider at this address
Other medical physician assistant providers in Broken Arrow
About NPI 1407120066
Jessica Laura Graves, PA-C's National Provider Identifier is 1407120066, issued on Feb 29, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Broken Arrow, OK. The record was last updated on May 18, 2026.