Individual
JODY GRAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP C
Contact information
Practice address
251 EAST AVE, LOCKPORT, NY 14094-3825
(716) 257-1248
(716) 215-6170
Mailing address
3117 MILITARY RD, NIAGARA FALLS, NY 14304-4813
(716) 297-2052
(716) 215-6170
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
136905
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
310425
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06835221
MEDICAID
NY
Enumeration date
08/23/2005
Last updated
10/06/2022
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