Individual
JENNIFER JANIECE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 OLD SPRINGFIELD RD, LEBANON, KY 40033-9185
(270) 765-2605
(270) 234-8572
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 234-8572
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1094778
KY
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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