Active NPI
Mary Ann Graham, REGISTERED NURSE
- Registered Nurse
- Wilmington, DE
National Provider Identifier
1063577534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- L1-0029074
- Practice address
- 1601 Kirkwood Hwy
Wilmington, DE 19805-4917 - Phone
- (302) 994-2511
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | L1-0029074 | DE | Primary |
Addresses
Primary practice location
1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Mailing address
132 Honora Dr
Bear, DE 19701-2042
Phone (302) 832-7615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0029074 | DE | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063577534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 HONORA DR",
"city": "BEAR",
"state": "DE",
"postal_code": "197012042",
"telephone_number": "302-832-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 KIRKWOOD HWY",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198054917",
"telephone_number": "302-994-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "REGISTERED NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "DE",
"license": "L1-0029074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.