Individual provider · Type 1 NPI
Lavern Graham, STUDENT
Student in an Organized Health Care Education/Training Program · Gordonville, TX
NPI number
1104287499
Active
Practice location
43 Plum Ln
Gordonville, TX 76245-2342
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1104287499
Lavern Graham, STUDENT's National Provider Identifier is 1104287499, issued on Mar 14, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Gordonville, TX. The record was last updated on Sep 29, 2026.