Provider Demographics
NPI:1831261064
Name:GRAHAM, DANIELLA CHRISTINA (WHNP (APRN))
Entity type:Individual
Prefix:MRS
First Name:DANIELLA
Middle Name:CHRISTINA
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:WHNP (APRN)
Other - Prefix:
Other - First Name:DANIELLA
Other - Middle Name:CHRISTINA
Other - Last Name:STOCKTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:5207 SUNSHINE PT
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-9129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4600 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3533
Practice Address - Country:US
Practice Address - Phone:713-522-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN652964163W00000X
TXAP113137363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150600804Medicaid