Provider Demographics
NPI:1114397486
Name:GRAHAM, SABRINA KELLI (ARNP)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:KELLI
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 SE 110TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-3118
Mailing Address - Country:US
Mailing Address - Phone:352-233-2360
Mailing Address - Fax:352-233-2363
Practice Address - Street 1:4850 SE 110TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3118
Practice Address - Country:US
Practice Address - Phone:352-233-2360
Practice Address - Fax:352-233-2363
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9297141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily