Provider Demographics
NPI:1891345039
Name:GRAHAM FAMILY CARE LLC
Entity Type:Organization
Organization Name:GRAHAM FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTITONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:270-547-8677
Mailing Address - Street 1:2025 BYPASS RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1605
Mailing Address - Country:US
Mailing Address - Phone:270-998-1064
Mailing Address - Fax:
Practice Address - Street 1:2025 BYPASS RD STE 205
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1605
Practice Address - Country:US
Practice Address - Phone:270-998-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty