Provider Demographics
NPI:1245940972
Name:GRAHAM, WILLIAM FREDRICK (RN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDRICK
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-2246
Mailing Address - Country:US
Mailing Address - Phone:480-484-8711
Mailing Address - Fax:
Practice Address - Street 1:8801 N 56TH ST
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-2246
Practice Address - Country:US
Practice Address - Phone:480-484-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ274734163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool