Graham, Michelle L

Graham, Michelle L is an individual health care provider with primary practice located at 15190 Community Rd Ste 300, Gulfport MS 39503-3485. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Graham, Michelle L can be contacted via phone (228) 831-2229.

Contact Information

Primary practice address
15190 Community Rd Ste 300 Gulfport MS 39503-3485
Phone: (228) 831-2229
Fax: (228) 831-9991
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R769918 Mississippi

Profile Details

NPI number 1578639548
LBN Legal business name Graham, Michelle L
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Aug 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578639548 NPPES
Mississippi MEDICAID 03983262

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