Individual
JANET JOANNE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
23500 KASSON ROAD, TRACY, CA 95304
(916) 282-9250
Mailing address
1510 S MILLS AVE APT 209, LODI, CA 95242-4239
(360) 798-6153
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
201130110LPN
OR
164W00000X
Licensed Practical Nurse
LP60325605
WA
164X00000X
Licensed Vocational Nurse
Primary
VN259361
CA
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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