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Individual

MRS. CLEO D GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.P

Contact information

Practice address
111 HOWLAND AVE, EAST PROVIDENCE, RI 02914-3054
(401) 438-6609
Mailing address
111 HOWLAND AVE, EAST PROVIDENCE, RI 02914-3054
(401) 438-6609

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
NPP23079
RI
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN23079
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22916-4
BLUE CROSS BLUE SHIELD
RI
01
28451
NEIGHBORHOOD HEALTH PLAN
RI
01
410545
BLUE CHIP
RI
Enumeration date
03/08/2007
Last updated
07/08/2007
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