KATHLEEN POWERS GRAHAM (NPI# 1407100357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407100357 |
| Entity Type | Individual |
| Full Name | KATHLEEN POWERS GRAHAM |
| Credential | NP-C |
| Practice Address |
15700 37th Ave N Ste 300 Plymouth MN 55446-3661 |
| Mailing Address |
1973 Sloan Pl Maplewood MN 55117-2084 |
| Practice Telephone | 6128711145 |
| Mailing Telephone | 6128711145 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2018-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A0712144 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
G0712013 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1831650829 | Kathleen Rose Graham | Student in an Organized Health Care Education/Training Program | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2019-03-31 |
| 1033683347 | Kathleen Graham | Registered Nurse | 4377 Bronx Blvd, Bronx, NY 10466-1397 | 2019-01-20 |
| 1043760200 | Kathleen Graham | Nurse Practitioner | 1900 N 9th St, Philadelphia, PA 19122 | 2016-10-11 |
| 1851658124 | Kathleen Wakefield Graham | Family Medicine | 4796 Caughlin Pkwy Ste 108, Reno, NV 89519-0910 | 2012-04-11 |
| 1811285547 | Kathleen Joan Graham | Physical Therapist | 6001 Westown Pkwy, West Des Moines, IA 50266-7702 | 2011-07-15 |
| 1437361003 | Kathleen Graham | Dentist | 101 B Parking Way, Lake Jackson, TX 77566 | 2007-05-04 |
| 1760465199 | Kathleen M Graham | Nurse Practitioner | 700 West Ave S, La Crosse, WI 54601-4783 | 2005-11-21 |
| Street Address |
15700 37TH AVE N STE 300 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55446-3661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205896511 | Polly A Nesset | Nurse Practitioner | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2006-03-23 |
| 1912360223 | Dina Khaled | Nurse Practitioner | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2016-04-04 |
| 1386999084 | Sara Louise Holsather | Physician Assistant | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2012-07-18 |
| 1215226386 | Birtukan Belew Cinnor | Internal Medicine | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2011-03-29 |
| 1447427588 | Jose Antonio Vega Peralta | Internal Medicine | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2008-05-08 |
| 1093832453 | Daniel Mark Van Handel | Internal Medicine | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114552379 | Molly M Mahoney | Pharmacist | 4110 Juneau Lane N, Plymouth, MN 55446 | 2020-03-09 |
| 1073064804 | Owen Payne Kusick | Student in an Organized Health Care Education/Training Program | 16717 49th Pl N, Plymouth, MN 55446 | 2016-10-17 |
| 1043696214 | Kari Shoemaker | Speech-Language Pathologist | 5855 Cheshire Parkway, Plymouth, MN 55446 | 2015-08-10 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1851715163 | Group Health Plan Inc | Clinic/Center | 5000 Fernbrook Ln N, Plymouth, MN 55446 | 2014-02-06 |
| 1588903009 | Laura Davidson | Physician Assistant | 3365 Plymouth Blvd., Suite 110, Plymouth, MN 55446 | 2013-02-04 |
| 1366680688 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6025 Shenandoah Ln N, Plymouth, MN 55446 | 2009-01-23 |
| 1205046646 | Merida A Miller | Obstetrics & Gynecology | 4155 Cty Rd 101 N, Plymouth, MN 55446 | 2007-05-23 |
| 1376684746 | West Metro Ophthalmology, Pa | Ophthalmology | 15655 37th Ave N Ste 200, Plymouth, MN 55446 | 2007-02-09 |
| 1952401390 | Grand St Paul Cvs LLC | Pharmacy | 4140 Rd 101 N, Plymouth, MN 55446 | 2006-09-25 |
| Find all providers in zip 55446 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821593138 | Kathleen Marie Smith | Nurse Practitioner | 44456 Brookside Rd, Plymouth, MI 48170-3848 | 2018-03-28 |
| 1306088265 | Lacey Lyn Schafer | Nurse Practitioner | W9071 Forest Dr, Plymouth, WI 53073 | 2009-03-24 |
| 1285879387 | Karen V Hebshie-bishop | Nurse Practitioner | 47 Obery St Ste 1a, Plymouth, MA 02360-2230 | 2008-12-04 |
| 1205896511 | Polly A Nesset | Nurse Practitioner | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2006-03-23 |
| 1568431583 | Anna Joyce Kennel | Nurse Practitioner | 2505 Oak Rd, Plymouth, IN 46563-9757 | 2006-03-14 |
| 1912360223 | Dina Khaled | Nurse Practitioner | 15700 37th Ave N Ste 300, Plymouth, MN 55446-3661 | 2016-04-04 |
| 1629444690 | Haven Home Physicians, PC | Nurse Practitioner | 408 S Main St, Plymouth, MI 48170-1709 | 2015-08-13 |
| 1942637434 | Barbara Greenwell | Nurse Practitioner | 101 Boulder Point Dr Ste 1, Plymouth, NH 03264-3170 | 2013-09-30 |
| 1811320997 | Katharine Schmid | Nurse Practitioner | 116 Court St, Plymouth, MA 02360-8710 | 2013-08-13 |
| 1265878987 | Casey C O'boyle | Nurse Practitioner | 45 Resnik Rd, Suite 202, Plymouth, MA 02360-4844 | 2013-05-21 |
| Find all providers in PLYMOUTH | ||||
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| 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.