Individual
MARIE A GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
636 WEST BROADWAY ST, NO LITTLE ROCK, AR 72114
(501) 374-1153
(501) 374-6213
Mailing address
636 WEST BROADWAY ST, NO LITTLE ROCK, AR 72114
(501) 374-1153
(501) 374-6213
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A003059
AR
363LA2100X
Acute Care Nurse Practitioner
Primary
ATP-000116
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ATP000116
LICENSE
AR
Enumeration date
12/24/2007
Last updated
10/31/2019
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