Laketta Graham

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703114735 Issued in MI

Practice address

2294 Chicago Blvd
Detroit, MI 48206-1739

Phone

(313) 974-8462

NPI assigned

Mar 25, 2015

Sex

Female

Sole proprietor

Yes

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1821482092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2294 CHICAGO BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061739",
            "telephone_number": "313-974-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2294 CHICAGO BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061739",
            "telephone_number": "313-974-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LAKETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703114735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Graham, B.S
• Clarice Graham, BA
• Devin Graham
• Isabella Graham, MD
• Jerry Graham Jr., MD
• Margaret Graham, MA, LPC
• Myriah Graham, MSW, LLMSW
• Pamela Graham, CNP
• Peggy Lois Graham, LMSW
• Theodore K Graham, MD

• Licensed Practical Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.