Individual
AMANDA RENEE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1210 GEMINI PL, COLUMBUS, OH 43240-6109
(614) 425-1610
Mailing address
2667 GLENDALE RD, GROVE CITY, OH 43123-3376
(614) 425-1610
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.471672
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0029389
OH
Other
Enumeration date
07/15/2021
Last updated
07/27/2021
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