Provider Demographics
NPI:1093577116
Name:GRAHAM, NIKEAH MONIQUE MADELINE
Entity Type:Individual
Prefix:
First Name:NIKEAH
Middle Name:MONIQUE MADELINE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CHESAPEAKE ST SE APT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3470
Mailing Address - Country:US
Mailing Address - Phone:202-491-8790
Mailing Address - Fax:
Practice Address - Street 1:2 M ST NE APT 1103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3988
Practice Address - Country:US
Practice Address - Phone:202-491-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide