Individual
COURTNEY R GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 248-5621
(573) 248-5264
Mailing address
6000 HOSPITAL DR., P.O. BOX 551, HANNIBAL, MO 63401-0551
(573) 248-5621
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C01442
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
146423
MO
367500000X
Certified Registered Nurse Anesthetist
209006952
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910840008
—
MO
Enumeration date
09/13/2006
Last updated
07/18/2022
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