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General NPI Number Information
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NPI Number | 1699108621
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Entity Type | Individual
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Provider Name | TONIA LANETTE GRAHAM FNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 20449 N LAKE PLEASANT RD STE 101
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City | PEORIA
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State | AZ
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Zip | 85382
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Country | US
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Telephone | 602-570-5587
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Fax |
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Provider Business Mailing Address
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Address Line | 20449 N LAKE PLEASANT RD STE 101
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City | PEORIA
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State | AZ
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Zip | 85382-2707
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Country | US
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Telephone |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP5186
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN088868
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP5186
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License Number State | AZ
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