SHANNON RENEE GRAHAM


Address: 4301 W Markham St, Little Rock, AR 72205-7101
Phone: 5015267425

SHANNON RENEE GRAHAM (NPI# 1538571575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538571575
Entity Type Individual
Full Name SHANNON RENEE GRAHAM
Other Name SHANNON RENEE BLACK
Credential APRN
Practice Address 4301 W Markham St
Little Rock
AR 72205-7101
Mailing Address 86 Krooked Kreek Cir
Cabot
AR 72023-3844
Practice Telephone 5015267425
Practice Fax Number 5016867217
Mailing Telephone 5016267877
Mailing Fax Number 5016867217
Enumeration Date 2014-05-27
Last Update Date 2014-05-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LX0001X Nurse Practitioner
Specialization: Obstetrics & Gynecology
A003719 AR Physician Assistants & Advanced Practice Nursing Providers

Other Providers SHANNON GRAHAM

NPI Name Taxonomy Address Enumeration
1649490665 Shannon Wilson Graham Clinical Nurse Specialist 400 Quail Creek Dr, Del Rio, TX 78840-2133 2007-05-01
1700357399 Shannon Lee Graham Occupational Therapist 34505 W 12 Mile Rd Ste 100, Farmington Hills, MI 48331-3287 2018-12-08
1710486873 Shannon Graham Counselor 9701 Apollo Dr Ste 245, Largo, MD 20774-4787 2018-02-05
1639683402 Shannon M. Graham Social Worker 41 Park Creek Dr, Greenville, SC 29605-4270 2017-11-30
1750738795 Shannon Graham Developmental Therapist 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 2016-05-19
1386988392 Shannon Janelle Graham Registered Nurse Duke University Medical Center 2301 Erwin Road, Durham, NC 27710 2012-11-15
1902193568 Shannon Graham Counselor 1115 Bethel Rd, Columbus, OH 43220-2690 2011-07-05

Office Location

Street Address 4301 W MARKHAM ST
City LITTLE ROCK
State AR
Zip Code 72205-7101

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811998487 Jan K Hastings Pharmacist 4301 W Markham St, #522, Little Rock, AR 72205-7101 2005-08-04
1043810971 Prashanth Reddy Damalcheruvu Student in an Organized Health Care Education/Training Program 4301 W Markham St, Little Rock, AR 72205-7199 2020-10-29
1114533619 Nitesh Gautam Student in an Organized Health Care Education/Training Program 4301 W Markham St, Little Rock, AR 72205-7101 2020-09-20
1891301818 Rachel Rosenbaum Nurse Practitioner 4301 W Markham St, Little Rock, AR 72205-7101 2020-09-16
1477164861 Ashtyn Leann Knowles Dietitian, Registered 4301 W Markham St, Little Rock, AR 72205-7101 2020-08-11
1700404118 Candace Johnson Social Worker 4301 W Markham St, Little Rock, AR 72205-7101 2020-07-12
1851919245 Omar Alqaisi Student in an Organized Health Care Education/Training Program 4301 W Markham St, Little Rock, AR 72205-7101 2020-07-11
1295364578 Julie Michelle Nessler Student in an Organized Health Care Education/Training Program 4301 W Markham St, Little Rock, AR 72205-7101 2020-04-07
1346879079 Brian Wesley Rhea Student in an Organized Health Care Education/Training Program 4301 W Markham St, Little Rock, AR 72205-7199 2020-04-04
1265060388 Erin Elizabeth Hall Student in an Organized Health Care Education/Training Program 4301 W Markham St, Slot 517, Little Rock, AR 72205-7101 2020-04-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932719465 Darleisha Renee Stigall Behavior Technician 1210 Aldersdate Rd, Little Rock, AR 72205 2020-08-10
1316563638 Unknown Amisha Student in an Organized Health Care Education/Training Program 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 2020-06-23
1225667272 Ann-marie Frances Hayre Student in an Organized Health Care Education/Training Program 4310 West Markham, Slot 589, Little Rock, AR 72205 2020-04-02
1952930075 Alexandria Leigh Smith Student in an Organized Health Care Education/Training Program 4301 West Markham St, Slot 531, Little Rock, AR 72205 2020-04-02
1093353922 Phil Fagala Pharmacist 614 North Beechwood, Little Rock, AR 72205 2019-12-10
1295391688 Home To Community Living, Inc Physical Therapist 10201 W Markham Street Pulaski, Little Rock, AR 72205 2019-05-12
1669933693 Sandy Louise Webb Student in an Organized Health Care Education/Training Program 4301 West Markham, Slot 530, Little Rock, AR 72205 2019-03-31
1457812828 Vincent Battafarano Student in an Organized Health Care Education/Training Program 4301 West Markham, Slot 602, Little Rock, AR 72205 2019-03-28
1063978922 Franks Pediatric Occupational Therapy LLC Occupational Therapist 5516 C St, Little Rock, AR 72205 2019-02-15
1497210199 Integrative Counseling Center LLC Counselor 10515 W Markham St Ste D3, Little Rock, AR 72205 2019-02-06
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Taxonomy Information

Taxonomy Code 363LX0001X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Obstetrics & Gynecology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689005993 Stacey Johnson Nurse Practitioner 4301 W Markham St # 519, Little Rock, AR 72205-7101 2013-12-12
1194074393 Crystal Dawn Marcussen Nurse Practitioner 4301 W Markham St # 547-07, Little Rock, AR 72205-7101 2012-09-04
1306211966 Sarah Holland Nurse Practitioner 1 Lile Ct Ste 200, Little Rock, AR 72205-6240 2015-12-08
1386060218 Amanda Kay Payne Nurse Practitioner 9601 Baptist Health Drive, Suite 1200, Little Rock, AR 72205 2014-03-17
1134550767 Megan Tucker Nurse Practitioner 5800 W 10th St, Little Rock, AR 72204-1752 2013-12-08
1063725711 Becca Carle Austin Nurse Practitioner 5 Saint Vincent Cir Ste 300, Little Rock, AR 72205 2010-07-23
1396060356 Tesa L Ivey Nurse Practitioner 4301 W Markham St, Slot 519, Little Rock, AR 72205-7101 2010-04-02
1801026620 Edwina Sue Walthall Nurse Practitioner 4301 W Markham St, Little Rock, AR 72205-7101 2009-07-15
1982847224 Ashley Brooke Keathley Nurse Practitioner 4301 W Markham St # 783, Little Rock, AR 72205-7101 2009-04-16
1396835880 Rosalyn Perkins Nurse Practitioner 4301 W Markham St # 783, Little Rock, AR 72205-7101 2006-10-13
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Competitor

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City LITTLE ROCK
Zip Code 72205

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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