Provider Demographics
NPI:1255894994
Name:GRAHAM, MICHELLE SLOAN (CRNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SLOAN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 POINT MALLARD PKWY SE STE N
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-5760
Mailing Address - Country:US
Mailing Address - Phone:256-432-2822
Mailing Address - Fax:256-432-2825
Practice Address - Street 1:2941 POINT MALLARD PKWY SE STE N
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-5760
Practice Address - Country:US
Practice Address - Phone:256-432-2822
Practice Address - Fax:256-432-2825
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily