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Individual

CHRISTIE LYNN GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
21297 OLEAN BLVD STE A, PORT CHARLOTTE, FL 33952-6704
(877) 856-3774
Mailing address
1859 OAKLAND RD, NORTH PORT, FL 34286-2017
(941) 916-0338

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11013462
FL

Other

Enumeration date
06/03/2021
Last updated
06/03/2021
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