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NPI Code Detail

MEDICARE: MARGARET GRAHAM CRNP

MEDICARE: MARGARET GRAHAM CRNP
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
1363LF0000XFamily Nurse PractitionerNP05769OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063588473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET GRAHAM CRNP
Provider Business Mailing Address
First Line : 2660 ECHO VALLEY DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45434-6743
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 141 W 3RD ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-1814
Country : US
Telephone Number : 937-222-9355
Fax Number : 937-331-5497
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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