Individual
JESSINA GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, C-NP
Contact information
Practice address
2921 LANDMARK PL STE 215, MADISON, WI 53713-4248
(405) 824-1705
(608) 299-3707
Mailing address
2921 LANDMARK PL SUITE 215, #418, MADISON, WI 53713-1825
(405) 824-1705
(405) 307-6660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
100661
OK
363L00000X
Nurse Practitioner
Primary
14613-33
WI
363LF0000X
Family Nurse Practitioner
100661
OK
Other
Enumeration date
08/06/2014
Last updated
11/30/2024
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