MRS. SANDRA GRAHAM (NPI# 1851835441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851835441 |
| Entity Type | Individual |
| Full Name | MRS. SANDRA GRAHAM |
| Other Name | SANDRA CHARLENE LEE GRAHAM |
| Credential | FNP |
| Practice Address |
101 Mcleod Health Blvd Ste 202 Myrtle Beach SC 29579-4477 |
| Mailing Address |
2160 Colonial Blvd. Fort Myers FL 33907 |
| Practice Telephone | 8432364949 |
| Practice Fax Number | 8432364746 |
| Mailing Telephone | (239) 931-7342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2018-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
20847 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 64997 | SC | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1851835441 | 05 | |
| SC | CIGNA | 7206002 | 01 |
| SC | SELECT HEALTH MEDICAID LINE OF BUSINESS | 30705179 | 01 |
| SC | UNITED HEALTHCARE | 6425288 | 01 |
| SC | AETNA | 4924376 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880572 | Sandra Graham | Chore Provider | 734 Burmont Rd, Drexel Hill, PA 19026-4322 | 2020-01-15 |
| 1790050284 | Sandra Decoursey Graham | Counselor | 4545 N 36th St Ste 102, Phoenix, AZ 85018-3473 | 2012-03-15 |
| 1336356955 | Sandra Dee Graham | Licensed Practical Nurse | 47 Finch St, Rochester, NY 14613-2236 | 2007-05-16 |
| 1215149109 | Sandra Graham | Occupational Therapist | 2280 S Minneapolis St, Wichita, KS 67211-5398 | 2007-05-04 |
| 1093780710 | Sandra E Graham | Psychologist | 10533 W National Ave, Suite 300, Milwaukee, WI 53227-2041 | 2006-02-17 |
| 1205451549 | Sandra A Graham | Pharmacist | 5040 Ritter Rd, Mechanicsburg, PA 17055-4879 | 2020-06-12 |
| 1336775451 | Sandra Graham | Registered Nurse | 1610 Miller Park Way, West Milwaukee, WI 53214-3604 | 2020-03-20 |
| 1750888913 | Sandra Jean Graham | Counselor | 680 Northland Blvd, Cincinnati, OH 45240-3248 | 2018-04-12 |
| 1013176171 | Sandra Graham | Case Manager/Care Coordinator | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2008-06-04 |
| 1629250998 | Sandra L Graham | Physical Therapist | 4315 Diplomacy Dr, Anmc - Physical Therapy Dept, Anchorage, AK 99508-5926 | 2007-11-28 |
| Street Address |
101 MCLEOD HEALTH BLVD STE 202 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29579-4477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323198 | P & E Company | Counselor | 4105 Carolina Commercial Dr. Unit #2, Myrtle Beach, SC 29579 | 2019-05-30 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1427518265 | Brian Donovan Doherty | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center 809 82nd Parkway, Gme Office, Myrtle Beach, SC 29579 | 2019-03-20 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1093232480 | Johnathan T Steppe | Dentist | 568 International Drive, Myrtle Beach, SC 29579 | 2017-08-25 |
| 1346638483 | Little River Medical Center, Inc | Clinic/Center | 4220 Carolina Exchange Blvd, Myrtle Beach, SC 29579 | 2014-12-23 |
| 1154726818 | Mina Gaid | Pharmacist | 1303 38th Avenue North, Myrtle Beach, SC 29579 | 2014-10-23 |
| 1528471364 | Paola Goyeneche | Counselor | 5015 Carolina Forest Blvd, Myrtle Beach, SC 29579 | 2014-06-10 |
| Find all providers in zip 29579 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671027 | Tara Sharay Woods | Nurse Practitioner | 215 Ronnie Ct Ste D, Myrtle Beach, SC 29579-4204 | 2019-10-24 |
| 1629611694 | Nancy Lauren Johnson | Nurse Practitioner | 101 Mcleod Health Blvd, Myrtle Beach, SC 29579-4477 | 2019-10-23 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1528569712 | Sarah Manglicmot Campos | Nurse Practitioner | 2050 Corporate Centre Dr Ste 220, Myrtle Beach, SC 29577-7428 | 2018-02-23 |
| 1679088793 | Maribeth Reid | Nurse Practitioner | 3236 Holmestown Rd Unit E1, Myrtle Beach, SC 29588-7495 | 2017-12-12 |
| 1184165714 | Emily Whitehurst | Nurse Practitioner | 3913 Carnegie Ave, Apt 216, Myrtle Beach, SC 29588-1144 | 2017-03-15 |
| 1487058434 | Ashley Adams | Nurse Practitioner | 4887 Socastee Blvd, Myrtle Beach, SC 29588-7245 | 2014-10-20 |
| 1699191262 | Tiffany Mahaffey | Nurse Practitioner | 1101 Brightwater Drive, Agape Physicians Care, Myrtle Beach, SC 29579 | 2014-03-06 |
| 1902235864 | Larissa Connell | Nurse Practitioner | 2510 N Kings Hwy, Myrtle Beach, SC 29577-3037 | 2013-11-01 |
| 1568585966 | Forest Family Practice, LLC | Nurse Practitioner | 3874 Renee Drive, Suite B, Myrtle Beach, SC 29579 | 2007-04-09 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
Please comment or provide details below to improve the information on MRS. SANDRA 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.