Amanda C Graham CRNA

NPI 1013067313 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1013067313
Gender Female
Enumeration Date 01/11/2007
Last Updated 01/09/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
15190 COMMUNITY RD
SUITE 230A
GULFPORT MS, 39503-3485, US
Phone (228) 831-0204
Fax (228) 831-1868
Business Location
15190 COMMUNITY RD
SUITE 230A
GULFPORT MS, 39503-3485, US
Phone (228) 831-0204
Fax (228) 831-1868
Toxanomy
Taxonomy Code 367500000X
License State Mississippi
License Number R860777
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According to our database, Amanda C Graham CRNA NPI is 1013067313, taxonomy code is 367500000X and license number is R860777, license state is located at Mississippi. Amanda C Graham CRNA physically located at 15190 Community Rd, Gulfport MS, 39503-3485. NPI Number Amanda C Graham CRNA has the Individual type.

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1013067313 NPI number is provided on an as is basis without warranty of any kind. 1013067313 is maintained by the National Plan & Provider Enumeration System. The contents of Amanda C Graham CRNA are for informational purposes only.