Individual
JENINE MARIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 251-2700
(320) 240-2830
Mailing address
11187 WOODS EDGE AVE, BECKER, MN 55308-4553
(763) 370-3515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005
MN
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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