Individual
MS. AMANDA KAY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7856
(321) 843-6432
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7856
(321) 843-6432
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
9375941
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11002696
FL
363LF0000X
Family Nurse Practitioner
11002696
FL
Other
Enumeration date
07/10/2019
Last updated
08/06/2019
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