Individual
KELLY FITZGIBBONS GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 HOLLYRIDGE TRL, MAITLAND, FL 32751-3671
(407) 545-0296
Mailing address
1230 HOLLYRIDGE TRL, MAITLAND, FL 32751-3671
(407) 545-0296
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
15010001
—
Other
Enumeration date
11/14/2020
Last updated
11/14/2020
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