LATISHA GRAHAM (NPI# 1780052555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780052555 |
| Entity Type | Individual |
| Full Name | LATISHA GRAHAM |
| Practice Address |
3188 Sag Harbor Ct Buford GA 30519-8604 |
| Practice Telephone | 9732205388 |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
A0615004 | GA | Allopathic & Osteopathic Physicians |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN212577 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065934 | Latisha Graham | Technician | 5135 Camino Al Norte Ste 150, North Las Vegas, NV 89031-2388 | 2019-10-23 |
| Street Address |
3188 SAG HARBOR CT |
| City | BUFORD |
| State | GA |
| Zip Code | 30519-8604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154880763 | Walter Kalenik | Physical Therapist | 3694 Lake Rabun Ct, Buford, GA 30519 | 2019-03-14 |
| 1083127500 | Bunmi Yemisi Folarinde | Nurse Practitioner | 3616 S Bogan Rd Ste 202, Buford, GA 30519 | 2017-11-06 |
| 1124546817 | Jenny Chang | Pharmacist | 2635 General Lee Way, Buford, GA 30519 | 2017-09-02 |
| 1588181853 | Vincent Spencer | Nurse Practitioner | 2128 Mill Garden Run, Buford, GA 30519 | 2017-08-27 |
| 1225567597 | Vincentia Paul-constantin | Clinic/Center | 2867 Country House Lane, Buford, GA 30519 | 2017-06-08 |
| 1043668361 | Jacob Matthew Minor | Chiropractor | 2725 Hamilton Rd, Ste 500, Buford, GA 30519 | 2016-05-26 |
| 1477910941 | Nicole Camp | Nurse Practitioner | 2725 Mall of Georgia Blvd, Buford, GA 30519 | 2016-01-28 |
| 1235519240 | Moyra Renee Betuzzi-teas | Obstetrics & Gynecology | 2527 Mall of Georgia Blvd, Buford, GA 30519 | 2015-06-04 |
| 1104250950 | Coyette Annisee Telemaque | Nurse Practitioner | 3331 Hamilton Mill Rd Ste 1102, Buford, GA 30519 | 2013-08-29 |
| 1649552134 | Indira Ashok Patel | Physical Medicine & Rehabilitation | 2839 Hidden Falls Drive, Buford, GA 30519 | 2011-09-12 |
| Find all providers in zip 30519 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275142994 | Theresia Richardson | Nurse Practitioner | 2033 Buford Hwy Ste 109, Buford, GA 30518-8802 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1427657113 | Cynthia Diane Prather | Nurse Practitioner | 3264 Lower Boston Rd, Thomasville, GA 31757-1311 | 2020-10-22 |
| 1932706728 | Alecia Ann Czarnecki | Nurse Practitioner | 6240 Crooked Creek Dr, Rex, GA 30273-5006 | 2020-10-05 |
| 1801401112 | Cotenna D. Clark | Nurse Practitioner | 1857 Cameo Ct, Tucker, GA 30084-7002 | 2020-09-14 |
| 1487264370 | Helen Young Yates | Nurse Practitioner | 40 Red Rock Ct Ne, Ludowici, GA 31316-6280 | 2020-08-05 |
| 1982214334 | Jasmine Alecia Henderson | Nurse Practitioner | 52 Roseberry Cir, Port Wentworth, GA 31407-5612 | 2020-07-31 |
| 1063021277 | Elsa Duncan Duncan | Nurse Practitioner | 1822 E Gwinnett St, Savannah, GA 31404-1853 | 2020-07-24 |
| 1154941946 | Joy P Wharton | Nurse Practitioner | 182 Silver Arrow Cir, Austell, GA 30168-7490 | 2020-04-21 |
| 1235769985 | Michelle Brack | Nurse Practitioner | 502 Hall Rd, Thomasville, GA 31757-8105 | 2020-01-22 |
| 1619513710 | Stefka Mentor | Nurse Practitioner | 2726 Raven Wood Dr, Snellville, GA 30078-3750 | 2019-11-23 |
| Find all providers with the same taxonomy | ||||
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| 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.