Individual
MICHELLE LYNN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
310 2ND AVE SW, 106-B, MIAMI, OK 74354-6743
(918) 540-7634
(918) 540-7641
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(918) 540-7634
(918) 540-7641
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
64927
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200038540A
—
OK
05
—
200468380W
—
OK
Enumeration date
02/22/2006
Last updated
04/05/2017
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