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Contact Information

KENITRA BROWN GRAHAM
460 BRIARWOOD DR
SUITE 510
JACKSON, MS39206-3051
 Phone: 601-956-4816
 Fax: 601-956-4817
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for KENITRA BROWN GRAHAM · (Female)

NPI # 1912430984
Status Active
Credentials
Entity Individual
Enumeration date 04/06/2017
Last updated 04/06/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MS Medicaid 01670076
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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