Individual
CATHLEEN JANE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1721 FESSLER ST, ENGLEWOOD, FL 34223-6427
(239) 565-4740
(239) 565-4740
Mailing address
1721 FESSLER ST, ENGLEWOOD, FL 34223-6427
(941) 460-8275
(941) 460-8275
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2962742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
591783920
CHAMPUS
—
01
—
G1925
BC/BS FL
FL
Enumeration date
02/15/2006
Last updated
05/19/2011
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