| Doctor Name: | MRS. CLEO D GRAHAM |
| NPI Number: | 1003947086 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N.P |
| License Number: | NPP23079 |
| Business Practice Address: | 111 Howland Ave East Providence, RI - 029143054 |
| Business Phone Number: | 4014386609 |
| Business Fax Number: | |
| Mailing Address: | 111 Howland Ave, EAST PROVIDENCE |
| State: | RI |
| Postal Code: | 029143054 |
| Phone Number: | 4014386609 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | NPP23079 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |