Provider Demographics
NPI:1720765779
Name:GRAHAM, SHEKINAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHEKINAH
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 JARMON CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-6114
Mailing Address - Country:US
Mailing Address - Phone:704-426-2611
Mailing Address - Fax:
Practice Address - Street 1:9841 NORTHLAKE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8930
Practice Address - Country:US
Practice Address - Phone:704-426-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist