| NPI | 1760953624 |
|---|---|
| Former Name | STEPHANIE JULIA GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9262855) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL APRN9262855) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9262855) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2021-09-24 |