Corinna Fiona Graham, LPN

Individual provider Active NPI Licensed Practical Nurse · Harriman, TN

NPI 1528596236 · NPPES record last updated May 24, 2017

Key facts

NPI
1528596236
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
0000087293 (TN)
Practice address
127 Amanda LN
Harriman, TN 37748-4750
Phone
(865) 361-0947
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
Yes

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
0000087293TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
164W00000X 0000087293 TN Yes

Addresses

Primary practice location

127 Amanda LN
Harriman, TN 37748-4750

Mailing address

127 Amanda LN
Harriman, TN 37748-4750

Other identifiers

IdentifierTypeStateIssuer
624094600OtherDOL

Other providers in Harriman, TN

All providers in Harriman, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.