TYNNETTA GRAHAM CRNP NPI 1578573440

NPI Information

  • NPI: 1578573440
  • Provider Name: TYNNETTA GRAHAM, CRNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1000 CATHEDRAL ST
    BALTIMORE, MD
    ZIP 21201
  • Phone: (410) 396-1295

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NPI Details

Tynnetta Graham, CRNP is a family nurse practitioner in Baltimore, MD with 31 years of experience. Tynnetta Graham, CRNP NPI is 1578573440. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1000 CATHEDRAL ST
BALTIMORE, MD
ZIP 21201-418
Phone: (410) 396-1295

The NPI 1578573440 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Telephone medical discussion with physician, 11-20 minutes (HCPCS:99442)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 8/9/2006 and was last updated on 4/18/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerR153464MARYLANDNo
2363LF0000XNurse PractitionerFamilyR153464MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1406596000MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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