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NPI Code Detail

MEDICARE: SUZAN UREGEN GRAHAM FNP-BC

MEDICARE: SUZAN UREGEN GRAHAM FNP-BC
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
1390200000XStudent in an Organized Health Care Education/Training Program109608SC
2363LF0000XFamily Nurse PractitionerAP61103979WA

General Provider Information

NPI Number : 1942877485
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZAN UREGEN GRAHAM FNP-BC
Provider Business Mailing Address
First Line : 4301 JONES BRIDGE RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-4799
Country : US
Telephone Number : 301-295-9004
Fax Number :
Provider Business Practice Location Address
First Line : 4301 JONES BRIDGE RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-4799
Country : US
Telephone Number : 301-295-9004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2021
Last Update Date : 04/29/2026

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