Provider Demographics
NPI:1356135180
Name:GRAHAM, SADE SEQUAN
Entity type:Individual
Prefix:
First Name:SADE
Middle Name:SEQUAN
Last Name:GRAHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 ARTHURS LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-7415
Mailing Address - Country:US
Mailing Address - Phone:330-322-9507
Mailing Address - Fax:
Practice Address - Street 1:225 COUNTRY CLUB DR STE 240
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7339
Practice Address - Country:US
Practice Address - Phone:770-810-6922
Practice Address - Fax:844-905-1406
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN309667163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse