Individual
AMANDA KRISTEN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
425 N LEE ST STE 203, JACKSONVILLE, FL 32204-1128
(904) 354-8200
(904) 354-1340
Mailing address
27 MARCO ISLAND WAY, PONTE VEDRA, FL 32081-0532
(904) 616-0322
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9201902
FL
363LA2100X
Acute Care Nurse Practitioner
ARNP9201902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308972000
—
FL
Enumeration date
02/26/2008
Last updated
09/12/2024
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