Renee Ann Graham, MSN, APRN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

6842 Issued in CT

Practice address

6 Storrs Rd Ste 4
Willimantic, CT 06226-4006

Phone

(860) 390-4590

NPI assigned

Nov 28, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Interoperability endpoints

• Direct secure messaging: renee.graham@395576857329668.direct.elationemr.com

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1982147740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 STORRS RD STE 4",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062264006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 STORRS RD STE 4",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062264006",
            "telephone_number": "860-390-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "6842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Reneetranquilityaesthetics@gmail.com",
            "affiliation": "N",
            "address_1": "6 Storrs Rd Ste 4",
            "city": "Willimantic",
            "state": "CT",
            "country_code": "US",
            "postal_code": "062264006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney M Goodwin
• John Phillip Gorman III
• Carly Gottehrer, LPC
• Aleksandr Y Gozun
• John N Graham, M.D.
• Karin E Grann, N.P.
• Christoher M Gratton
• Tracy M Gratton, R.D.H.
• Steven J Green, MD
• Jasminka Hasan Grgas, LPC

• Acute Care Nurse Practitioner in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Acute Care Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.