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Individual

NICOLE TERESA GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
753 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4312
(678) 701-6397
Mailing address
753 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4312
(678) 701-6397

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9314135
FL
363L00000X
Nurse Practitioner
Primary
NP336359
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P5040
MEDICARE HF
FL
Enumeration date
10/28/2014
Last updated
05/12/2026
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