Individual
KIMBERLY DANE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
250 HOSPICE CIR, RALEIGH, NC 27607-6372
(919) 828-0890
Mailing address
250 HOSPICE CIR, RALEIGH, NC 27607-6372
(919) 828-0890
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900289
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500026240
RAILROAD-MEDICARE
NC
Enumeration date
09/12/2006
Last updated
05/17/2012
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