Individual
KATIE MARIE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1980 TAMARACK RD, NEWARK, OH 43055-1363
(220) 564-7520
Mailing address
1980 TAMARACK RD, NEWARK, OH 43055-1363
(220) 564-7520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.16759
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.16759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113641
—
OH
Enumeration date
10/29/2014
Last updated
12/09/2022
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