Active NPI
Marie E Graham, CRNP
- Family Medicine Physician
- Drexel Hill, PA
National Provider Identifier
1962441642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TP004825C
- Practice address
- 3400 Garrett Rd
Suite a
Drexel Hill, PA 19026-2940 - Phone
- (610) 626-0940
- Fax
- (610) 626-7615
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TP004825C | PA | Primary |
Addresses
Primary practice location
3400 Garrett Rd
Suite a
Drexel Hill, PA 19026-2940
Mailing address
3400 Garrett Rd
Suite a
Drexel Hill, PA 19026-2940
Phone (610) 626-0940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279584000000",
"number": "1962441642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 GARRETT RD",
"address_2": "SUITE A",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190262940",
"telephone_number": "610-626-0940",
"fax_number": "610-626-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 GARRETT RD",
"address_2": "SUITE A",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190262940",
"telephone_number": "610-626-0940",
"fax_number": "610-626-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "MARIE",
"middle_name": "E",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2010-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "TP004825C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.