Mary Virginia Graham, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP460472 Issued in FL

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(180) 930-8838

Fax

(386) 719-3622

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199491200000",
    "number": "1740378579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5127 NW 62ND ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326534073",
            "telephone_number": "352-379-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "180-930-8838",
            "fax_number": "386-719-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP460472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Gordon
• Justin Kyle Goss
• Sheel Goswami
• Grace Pediatrics PL
• Ashley Graham
• Tina Graham
• Reba A Gramling
• Grande Cypress Alf LLC
• Amber Renee Granger Baughman
• Wiley Grantham IV

• Adult Health Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.