MEDICARE: ALLISON BRIDGES GRAHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	217179	LA

General Provider Information

NPI Number	:	1184588634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON BRIDGES GRAHAM

Provider Business Mailing Address
First Line	:	8585 PICARDY AVE STE 318
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3749
Country	:	US
Telephone Number	:	225-333-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	8585 PICARDY AVE STE 318
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3749
Country	:	US
Telephone Number	:	225-333-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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