Individual
REBECCA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
1569 SILVER LAKE RD, LANGHORNE, PA 19047-8001
(215) 260-0751
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP018727
PA
363LP0200X
Pediatric Nurse Practitioner
SP018824
PA
Other
Enumeration date
04/20/2018
Last updated
11/14/2019
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