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General NPI Number Information
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NPI Number | 1215733050
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Entity Type | Individual
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Provider Name | LESLIE ELAINE GRAHAM DNP, AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1455 UNION AVE
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City | MEMPHIS
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State | TN
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Zip | 38104-6727
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Country | US
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Telephone | 901-726-6655
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Fax | 901-726-9056
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Provider Business Mailing Address
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Address Line | 47 S MENDENHALL RD
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City | MEMPHIS
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State | TN
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Zip | 38117-3315
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Country | US
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Telephone | 901-581-6414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 214186
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 38284
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License Number State | TN
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