Provider Demographics
NPI:1992072524
Name:GRAHAM, PATTON DOUGLAS (NP-C)
Entity type:Individual
Prefix:
First Name:PATTON
Middle Name:DOUGLAS
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 ARNO COLLEGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE GROVE
Mailing Address - State:TN
Mailing Address - Zip Code:37046-9130
Mailing Address - Country:US
Mailing Address - Phone:615-772-4710
Mailing Address - Fax:
Practice Address - Street 1:6419 ARNO COLLEGE GROVE RD
Practice Address - Street 2:
Practice Address - City:COLLEGE GROVE
Practice Address - State:TN
Practice Address - Zip Code:37046-9130
Practice Address - Country:US
Practice Address - Phone:615-772-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20562363LF0000X
TN191940163WH0200X, 163W00000X
TN37540146N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program