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Individual

ANGELA FERGUSON GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
159 HARTLEY WAY, PEARISBURG, VA 24134-2471
(540) 853-0201
(540) 853-0931
Mailing address
44 HILLCREST ESTATES LOOP, PETERSTOWN, WV 24963-1118
(304) 557-9822

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001195632
VA
363L00000X
Nurse Practitioner
0024177989
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001195632
VA BOARD OF NURSING
VA
01
0024177989
APRN NURSE PRACTITIONER
VA
Enumeration date
07/02/2019
Last updated
11/12/2019
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