| Vanessa Graham Np | |
|
5960 Fairview Rd Ste 400 Charlotte NC 28210-3119 | |
| (704) 267-6905 | |
| Not Available |
| Full Name | Vanessa Graham Np |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5960 Fairview Rd Ste 400, Charlotte, North Carolina |
| Authorized Official Name and Position | Vanessa Graham (OWNER) |
| Authorized Official Contact | 9804833015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanessa Graham Np 5960 Fairview Rd Ste 400 Charlotte NC 28210-3119 Ph: (980) 483-3015 | Vanessa Graham Np 5960 Fairview Rd Ste 400 Charlotte NC 28210-3119 Ph: (704) 267-6905 |
| NPI Number | 1659940823 |
|---|---|
| Provider Enumeration Date | 06/22/2021 |
| Last Update Date | 07/18/2022 |
| Certification Date | 07/18/2022 |
| Medicare PECOS PAC ID | 9335597988 |
|---|---|
| Medicare Enrollment ID | O20231121001707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659940823 | NPI | - | NPPES |
| 1336693266 | Medicaid | NC |
| Provider Name | Vanessa Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336693266 PECOS PAC ID: 7113206715 Enrollment ID: I20161123001149 |
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