Graham, Vivian L

Graham, Vivian L is an individual health care provider with primary practice located at 1020 New River Pkwy Ste 200 , Fallon NV 89406-7801. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Graham, Vivian L can be contacted via phone (775) 428-2150.

Contact Information

Primary practice address
1020 New River Pkwy Ste 200 Fallon NV 89406-7801
Phone: (775) 428-2150
Fax: (775) 428-2151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 809 Nevada

Profile Details

NPI number 1437128873
LBN Legal business name Graham, Vivian L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Jul 21st, 2022 - about 2 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 1437128873 NPPES
Other 11536093 CAQH
MEDICAID 1437128873 CAQH

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