Provider Demographics
NPI:1194586719
Name:GRAHAM, DAVETTE F
Entity type:Individual
Prefix:
First Name:DAVETTE
Middle Name:F
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 P ST SW APT 22
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3545
Mailing Address - Country:US
Mailing Address - Phone:202-840-9924
Mailing Address - Fax:
Practice Address - Street 1:68 P ST SW APT 22
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3545
Practice Address - Country:US
Practice Address - Phone:202-840-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1621846376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker