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NPI Code Detail

MEDICARE: CORRIN GRAHAM RN

MEDICARE: CORRIN GRAHAM RN
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
1163WE0003XEmergency Registered NurseRN902297ME

General Provider Information

NPI Number : 1831058098
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORRIN GRAHAM RN
Provider Business Mailing Address
First Line : 11 ROUGH RIDER RD
Second Line :
City : DURHAM
State : ME
Zip : 04222-5264
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3175
Country : US
Telephone Number : 207-662-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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