Individual
KATHLEEN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
1900 N 9TH ST, PHILADELPHIA, PA 19122
(215) 765-6690
(215) 765-6694
Mailing address
1500 MARKET ST. WEST TOWER, LM 500, PHILADELPHIA, PA 19102
(215) 985-2500
(267) 765-2325
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP019911
PA
363LP2300X
Primary Care Nurse Practitioner
AP60690424
WA
Other
Enumeration date
10/11/2016
Last updated
08/22/2019
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