Individual
JOHN RICHARD GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LANE, CHARLOTTE, NC 28204
(704) 384-4239
(704) 384-5636
Mailing address
1525 W CYPRESS CREEK RD, FORT LAUDERDALE, FL 33309
(954) 939-5000
(954) 939-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
054220
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9196509
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051998
—
NC
05
—
NAN512
—
SC
Enumeration date
05/04/2006
Last updated
06/06/2025
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