Individual
TAMMY TERESA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 231-6132
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(877) 498-4490
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
172528
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104421510
—
NC
Enumeration date
12/02/2020
Last updated
02/14/2023
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