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Individual

MRS. ANGELA GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
17509 HIGHWAY 21 SOUTH, SEBASTOPOL, MS 39359-0082
(601) 267-1320
(601) 267-5422
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855944
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0123601
MS
Enumeration date
06/29/2006
Last updated
11/12/2025
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