Individual
MARY L GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-7000
Mailing address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP000222
SD
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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