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Individual

LAURA GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4877
(219) 663-4877
Mailing address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4877
(219) 663-4877

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005996A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71005996A
APN LICENSE
IN
Enumeration date
12/29/2015
Last updated
07/04/2021
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