Coleen Fenna Graham, RN
Individual provider Active NPI Home Health Registered Nurse · Bristol, WI
NPI 1952297541 · NPPES record last updated Jun 18, 2025
Key facts
- NPI
- 1952297541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 21327922 (WI)
- Practice address
- 12940 79TH PL
Bristol, WI 53104-8922 - Phone
- (801) 380-3159
- NPI assigned
- Jun 18, 2025
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21327922 | WI | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 21327922 | WI | Yes |
Addresses
Primary practice location
12940 79TH PL
Bristol, WI 53104-8922
Mailing address
12940 79TH PL
Bristol, WI 53104-8922
Phone (801) 380-3159
Other providers in Bristol, WI
- Nancy Dawn Anderson
- Rhea Bovee
- Bristol Fire & Rescue
- Bristol School District #1
- Kathleen M Bullard
- Heal From Within
- KB Counseling & Emdr LLC
- Kristin Marie Keeler
- Whittney Koepnick
- Kristin M Keeler, S.C
All providers in Bristol, WI · Home Health Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. 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.