Individual
DEEANA ERICA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4016 LOUISIANA BLVD NE, ALBUQUERQUE, NM 87110-1447
(505) 884-0307
Mailing address
8323 SANTA CLARITA ST NE, ALBUQUERQUE, NM 87113-2839
(505) 695-0180
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009147
NM
Other
Enumeration date
08/01/2019
Last updated
04/15/2021
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