Sandra Graham

Individual provider Active NPI Registered Nurse · West Milwaukee, WI

NPI 1336775451 · NPPES record last updated Mar 20, 2020

Key facts

NPI
1336775451
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
168033-30 (WI)
Practice address
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone
(414) 499-1750
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
168033-30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 168033-30 WI Yes

Addresses

Primary practice location

1610 Miller Park Way
West Milwaukee, WI 53214-3604

Mailing address

3135 S 10TH St
Milwaukee, WI 53215-4729
Phone (414) 499-1750

Other providers in West Milwaukee, WI

All providers in West Milwaukee, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.