| Mrs Omega Denise Graham, PMHNP | |
|
378 Wallace St, Lake City, SC 29560-4108 | |
| (843) 373-0569 | |
| Not Available |
| Full Name | Mrs Omega Denise Graham |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 378 Wallace St, Lake City, South Carolina |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225606890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 24831 (South Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eventus Wholehealth Pllc | 6002169539 | 309 |
| Entity Name | Ch Specialty Services Sc Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275915522 PECOS PAC ID: 6608182993 Enrollment ID: O20150901002450 |
| Entity Name | Elite Patient Care Of South Carolina Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316477896 PECOS PAC ID: 1951672617 Enrollment ID: O20170731000866 |
| Entity Name | Eventus Wholehealth Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548759392 PECOS PAC ID: 6002169539 Enrollment ID: O20190402002780 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Omega Denise Graham, PMHNP Po Box 901, Lake City, SC 29560-0901 Ph: (843) 373-0569 | Mrs Omega Denise Graham, PMHNP 378 Wallace St, Lake City, SC 29560-4108 Ph: (843) 373-0569 |
Mrs. Margaret Elaine Tanner, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 137 N Acline St, Lake City, SC 29560 Phone: 843-394-8822 Fax: 843-394-8856 | |
Diana Lee Collins, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 148 Sauls St, Lake City, SC 29560 Phone: 843-374-3621 | |
Mrs. Allison Campbell, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 137 N Acline St, Lake City, SC 29560 Phone: 843-394-8822 | |
Ms. Sarah Lisa Frierson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1278 Moore St, Lake City, SC 29560 Phone: 843-389-7251 | |
Dominique Sophia Destiny Speaks, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 652 N Matthews Rd, Lake City, SC 29560 Phone: 843-432-3677 | |
Jessica Mckenzie Grimsley, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 276 N Ron Mcnair Blvd, Lake City, SC 29560 Phone: 843-394-5471 |