Provider Demographics
NPI:1275638454
Name:GRAHAM, ELIZABETH BRADLEY (RN MSN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRADLEY
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9030 E BERKSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-3015
Mailing Address - Country:US
Mailing Address - Phone:520-721-2139
Mailing Address - Fax:520-629-1860
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:MAIL CODE 1-111
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:520-629-1860
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN030054163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control