Individual
ANNETTE S GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
5507 DORCHESTER RD, RICHMOND, VA 23225-3019
(804) 282-6953
Mailing address
5507 DORCHESTER RD, RICHMOND, VA 23225-3019
(804) 282-6953
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024166681
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01120
MEDICARE GROUP PTAN
VA
01
—
C05844
MEDICARE GROUP PTAN
VA
Enumeration date
04/13/2006
Last updated
03/25/2014
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