| NPI | 1467171884 |
|---|---|
| Former Name | JESSICA LYN GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: CO C-APN.0992701-C-NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CO C-APN.0992701-C-NP) |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2023-01-12 |