Individual
NICOLE ELIZABETH GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5 GEORGETOWN CT, MADISON, WI 53719-2205
(608) 622-1133
Mailing address
5 GEORGETOWN CT, MADISON, WI 53719-2205
(608) 622-1133
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307035-031
WI
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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