Healthcare Provider Details

I. General information

NPI: 1831315050
Provider Name (Legal Business Name): MRS. PATRICIA D BARTHOLOMEW GRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4972 THORNHILL LN
DUBLIN OH
43017
US

IV. Provider business mailing address

3479TOPGALLANT CT.
COLUMBUS OH
43221
US

V. Phone/Fax

Practice location:
  • Phone: 614-678-0477
  • Fax:
Mailing address:
  • Phone: 614-529-0099
  • Fax: 614-771-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN224123
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: