MICHELLE L GRAHAM CFNP NPI 1578639548

NPI Information

NPI: 1578639548
Provider Name: MICHELLE L GRAHAM, CFNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SUN COAST PAIN MANAGEMENT, P.A.

PECOS Registration: Yes

Address:
15190 COMMUNITY RD
STE 300
GULFPORT, MS
ZIP 39503
Phone: (228) 831-2229
Get Directions

Michelle L Graham, CFNP is a family nurse practitioner in Gulfport, MS with 21 years of experience. Michelle L Graham, CFNP NPI is 1578639548. 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:

15190 COMMUNITY RD
STE 300
GULFPORT, MS
ZIP 39503-485
Phone: (228) 831-2229
Fax: (228) 831-9991

The NPI 1578639548 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 enumeration date for this NPI number is 11/28/2006 and was last updated on 8/17/2018.

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
1	363LF0000X	Nurse Practitioner	Family	R769918	MISSISSIPPI	Yes

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
1	03983262	MEDICAID	MISSISSIPPI
2	$$$$$$$$$A	OTHER	MISSISSIPPI	BCBS OF MS

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: 11/14/2023

NPI Synchronization or Removal

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