Individual
MS. STEPHANIA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4213 W RUBY AVE, MILWAUKEE, WI 53209-5849
(414) 915-7357
Mailing address
4213 W RUBY AVE, MILWAUKEE, WI 53209-5849
(414) 915-7357
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308347031
WI
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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