Provider Demographics
NPI:1851519862
Name:GRAHAM, ZANYA DINELLE (CPNP)
Entity Type:Individual
Prefix:
First Name:ZANYA
Middle Name:DINELLE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ZANYA
Other - Middle Name:DINELLE
Other - Last Name:RAINEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3401 PANTHER PRIDE DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2184
Mailing Address - Country:US
Mailing Address - Phone:703-441-4291
Mailing Address - Fax:703-441-4497
Practice Address - Street 1:3401 PANTHER PRIDE DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2184
Practice Address - Country:US
Practice Address - Phone:703-441-4291
Practice Address - Fax:703-441-4497
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165725363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics