Provider Demographics
NPI:1619673084
Name:GRAHAM-MURRAY, SIMONE ALTHEA (NP)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:ALTHEA
Last Name:GRAHAM-MURRAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:ALTHEA
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:214 TRENTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-4114
Mailing Address - Country:US
Mailing Address - Phone:781-888-8522
Mailing Address - Fax:
Practice Address - Street 1:214 TRENTWOOD PL
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-4114
Practice Address - Country:US
Practice Address - Phone:781-888-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA215763363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health