Healthcare Provider Details

I. General information

NPI: 1083521843
Provider Name (Legal Business Name): GABRIELLE GRAHAM APRN-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHRISTUS TRINITY MOTHER FRANCIS 1509 TX-19
ATHENS TX
75751
US

IV. Provider business mailing address

391 FREDERICK CIR
FLINT TX
75762-9009
US

V. Phone/Fax

Practice location:
  • Phone: 903-606-4262
  • Fax:
Mailing address:
  • Phone: 903-606-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number1118168
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: