Provider Demographics
NPI:1316792930
Name:GRAHAM, AURORA ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:ELIZABETH
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7530
Mailing Address - Country:US
Mailing Address - Phone:866-806-8235
Mailing Address - Fax:
Practice Address - Street 1:1509 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7530
Practice Address - Country:US
Practice Address - Phone:866-806-8235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1154084363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner