MRS. KALLIE RENEE GRAHAM (NPI# 1972078632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972078632 |
| Entity Type | Individual |
| Full Name | MRS. KALLIE RENEE GRAHAM |
| Credential | APRN, NNP-BC |
| Practice Address |
701 Park Ave Minneapolis MN 55415-1623 |
| Mailing Address |
347 Wedgewood Dr Mahtomedi MN 55115-1783 |
| Practice Telephone | 6128732955 |
| Mailing Telephone | 6123849987 |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
6255 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
701 PARK AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55415-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750387734 | David C Templeman | Orthopaedic Surgery | 701 Park Ave, Department of Orthopedics, Minneapolis, MN 55415-1623 | 2005-06-23 |
| 1164029336 | James Wayne Fisher | Psychologist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-10-01 |
| 1396351482 | Emily Ann Beck | Physical Therapist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-09-23 |
| 1932714524 | Manju Elizabeth Alexander | Psychologist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-09-10 |
| 1043838675 | Ayan Hashi | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-07-09 |
| 1366068561 | Roberto Emilio Fu Carrasco | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-06-23 |
| 1104448810 | Michael Berryman | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-05-15 |
| 1811519192 | Viktoriya A. Ishchuk | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-05-10 |
| 1861014235 | Abdurahman Salah Ibrahim | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-05-08 |
| 1962024430 | Timothy Baerg | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2020-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114547643 | Kevin Reininger | Pharmacist | 730 S 8th St., Pharmacy Department, Minneapolis, MN 55415 | 2020-04-24 |
| 1124674551 | Andrew Michael Baker | Pathology | Hennepin County Medical Examiner, 530 Chicago Ave, Minneapolis, MN 55415 | 2019-08-12 |
| 1598326951 | Monazza Iqbal Chaudhry | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center 701 Park Avenue, Minneapolis, MN 55415 | 2019-06-26 |
| 1760947196 | Brandon Haas | Pharmacist | 701 Park Ave Rll, Minneapolis, MN 55415 | 2019-02-11 |
| 1710474192 | Andrea Kramer | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center Emergency Medicine, 701 Park Avenue, Minneapolis, MN 55415 | 2018-04-20 |
| 1750888640 | Alexandra Rose Coward | Student in an Organized Health Care Education/Training Program | Hennepin County Medical Center - General Surgery, 701 Park Avenue, Minneapolis, MN 55415 | 2018-04-09 |
| 1194235861 | Gretchen Jane Vanderlinden-wang | Social Worker | Hennepin County Medical Center Adult Psychiatry Clinic, 701 Park Avenue, Shapiro Building, Suite S1.110, Minneapolis, MN 55415 | 2017-10-06 |
| 1720501117 | Dominique Lacha Jones | Advanced Practice Midwife | 716 South 7th Street, Purple Building Level 5, Minneapolis, MN 55415 | 2017-07-18 |
| 1669905618 | Joseph Douglas Steffens | Internal Medicine | 701 Park Avenue, Internal Medicine Residency Program, Hennepin County Medical Center, Minneapolis, MN 55415 | 2017-04-06 |
| 1215469689 | Michael Reitz | Student in an Organized Health Care Education/Training Program | 701 Park Avenue, B5.118, Minneapolis, MN 55415 | 2017-04-03 |
| Find all providers in zip 55415 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356502124 | Nannette Marie Albright | Nurse Practitioner | Children's Minnesota, 2525 Chicago Avenue South, Minneapolis, MN 55404 | 2008-06-24 |
| 1255930202 | Gershom Aaron Tam | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-10-21 |
| 1184244139 | Ahnalieza Marie Brill | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-04-20 |
| 1063069284 | Korena Marie Katherine Kemerling-theobald | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2019-08-22 |
| 1538641592 | Melissa Luanne Masselink | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2018-09-05 |
| 1003354853 | Maria A Andrews | Nurse Practitioner | 2525 Chicago Avenue South, Minneapolis, MN 55404-4518 | 2017-02-01 |
| 1407309214 | Erin Gorham | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2016-07-27 |
| 1922455591 | Jessica Ann Perry | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2016-05-24 |
| 1720432768 | Kaylee Michael Adams | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2016-04-15 |
| 1306219217 | Lauren Guerrero | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2015-11-02 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55415 |
Please comment or provide details below to improve the information on MRS. KALLIE RENEE 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.