SHENELL DOMINIQUE GRAHAM (NPI# 1750943817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750943817 |
| Entity Type | Individual |
| Full Name | SHENELL DOMINIQUE GRAHAM |
| Credential | PMHNP |
| Practice Address |
640 Independence Pkwy # 200 Chesapeake VA 23320-5205 |
| Mailing Address |
648 Independence Pkwy Ste 400 Chesapeake VA 23320-5207 |
| Practice Telephone | 7574200530 |
| Mailing Telephone | 5138857070 |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2020-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
0024177787 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1913 Flyway Br, Chesapeake, VA 233225371 | 5138857070 | |
| 850 Tidewater Dr, Norfolk, VA 235043300 | 7573336992 |
| Street Address |
640 INDEPENDENCE PKWY # 200 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23320-5205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1538624804 | Shaniqah Mcleod | Home Health | 217 Centerville Turnpike N, Chesapeake, VA 23320 | 2019-01-31 |
| 1942764113 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1400 Kempsville Rd, Virginia Beach, VA 23320 | 2019-01-22 |
| 1639647993 | Madison Vansavage Maben | Orthotist | 433 Network Sta, Chesapeake, VA 23320 | 2018-11-05 |
| 1568947356 | Kelly M Muchetti | Massage Therapist | 1421 C. Kempsville Rd., Chesapeake, VA 23320 | 2018-09-27 |
| 1235612912 | L&s Home Health Care, LLC. | Home Health | 1545 Cossways Blv, Chesepeake, VA 23320 | 2018-09-10 |
| 1154803500 | Latricia A Patterson | Home Health | 813-a Professional Pl Ste 107, Chesapeake, VA 23320 | 2018-09-02 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1831676105 | Lance Taylor | Technician | 1645 Crossways Blvd Ste 250, Chesapeake, VA 23320 | 2018-07-19 |
| 1023507688 | Sentoria Howell Harold | Social Worker | 920 Ventures Way Ste 4, Chesapeake, VA 23320 | 2018-05-08 |
| Find all providers in zip 23320 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679185573 | Shaping Your Future Psychiatry | Nurse Practitioner | 1534 Bateau Lndg, Chesapeake, VA 23321-6603 | 2020-08-20 |
| 1356993448 | Edith Kathleen Jones | Nurse Practitioner | 1109 Norcova Ct, Chesapeake, VA 23320-5013 | 2019-07-10 |
| 1427525294 | Alpha Psychiatric Services, LLC | Nurse Practitioner | 2005 Old Greenbrier Rd Ste 104, Chesapeake, VA 23320-2649 | 2018-10-30 |
| 1396112538 | Thomas Kannon | Nurse Practitioner | 828 Greenbrier Pkwy Ste 210, Chesapeake, VA 23320-3684 | 2015-08-24 |
| 1558929190 | Katlyn B Tillett | Nurse Practitioner | 640 Independence Pkwy Ste 100, Chesapeake, VA 23320-5205 | 2019-05-29 |
| 1114354636 | Shayne O'neal Morris | Nurse Practitioner | 860 Greenbrier Cir, Suite 100, Chesapeake, VA 23320-2640 | 2013-09-29 |
| 1457695173 | Samuel Isaac Harris | Nurse Practitioner | 1417 Battlefield Blvd N Ste 260, Chesapeake, VA 23320 | 2012-11-19 |
| 1720342272 | Craig Allen Tyson Sr. | Nurse Practitioner | 860 Greenbrier Cir, Suite 100, Chesapeake, VA 23320-2640 | 2012-06-29 |
| 1093013641 | Justin T Ray | Nurse Practitioner | 224 Great Bridge Blvd, Chesapeake, VA 23320-3904 | 2011-03-07 |
| 1992956171 | Sherry Hall | Nurse Practitioner | 224 Great Bridge Blvd, Chesapeake, VA 23320-3904 | 2008-10-06 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23320 |
Please comment or provide details below to improve the information on SHENELL DOMINIQUE GRAHAM.
| 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.