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NPI Code Detail

MEDICARE: DEBRA LAWSON GRAHAM RN

MEDICARE: DEBRA LAWSON GRAHAM RN
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
1163WC0400XCase Management Registered NurseR0063853OK

General Provider Information

NPI Number : 1730200825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LAWSON GRAHAM RN
Provider Business Mailing Address
First Line : PO BOX 265
Second Line :
City : ROFF
State : OK
Zip : 74865-0265
Country : US
Telephone Number : 580-456-7726
Fax Number :
Provider Business Practice Location Address
First Line : 1308 CRADDUCK RD
Second Line :
City : ADA
State : OK
Zip : 74820-8442
Country : US
Telephone Number : 580-332-3699
Fax Number : 580-421-9828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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