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Individual

ARIEL TAWANDA GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPCNP-C

Contact information

Practice address
622 SW 52ND ST, CAPE CORAL, FL 33914-6518
(727) 212-3249
Mailing address
4480 46TH AVE N, ST PETERSBURG, FL 33714-2904
(727) 212-3249

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
9367877
FL
363LG0600X
Gerontology Nurse Practitioner
9367877
FL

Other

Enumeration date
09/24/2018
Last updated
09/24/2018
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