Irene Graham, RN
Individual provider Active NPI Registered Nurse · Willow Creek, CA
NPI 1134589237 · NPPES record last updated Mar 2, 2016
Key facts
- NPI
- 1134589237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 798692 (CA)
- Practice address
- 38883 Hwy 299
Willow Creek, CA 95573-0726 - Phone
- (530) 629-3111
- Fax
- (530) 629-3122
- NPI assigned
- Mar 2, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 798692 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Community Health Centers | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 798692 | CA | Yes |
Addresses
Primary practice location
38883 Hwy 299
Willow Creek, CA 95573-0726
Mailing address
670 9TH St
Arcata, CA 95521-6248
Phone (707) 826-8633
Other providers in Willow Creek, CA
- Brenda Lee Elkins
- John Evans
- Linda Ann Gardner
- Suzanne Garrett
- Mary Genoar
- John L Greenwood
- Roland N Grubb
- Sydney Haynes
- Shari Rachelle Hostler
- Humboldt County Behavioral Health
All providers in Willow Creek, CA · Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.