LISA ELIZABETH GRAHAM
NPI 1912886045
Military Health Care Provider - Independent Duty Medical Technicians in Grand Rapids, MI

Active since September 02, 2025
4218 BURTON ST SE, GRAND RAPIDS, MI 49546(616) 301-8000 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lisa Elizabeth Graham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA ELIZABETH GRAHAM (NPI 1912886045) is an individual independent duty medical technicians provider in Grand Rapids, Michigan and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1912886045
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameLISA ELIZABETH GRAHAM
Location Address4218 BURTON ST SEGrand Rapids, MI 49546-6121
Mailing Address4218 Burton St SeGrand Rapids, MI 49546-6121 · (616) 301-8000
Sole ProprietorNo
Enumeration DateSeptember 2, 2025
NPPES CertifiedSeptember 2, 2025
NPI 1912886045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Also ListedTechnician · Personal Care AttendantTaxonomy 3747P1801X
4218 BURTON ST SE, Grand Rapids, MI 49546

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Graham's NPI number?

The NPI number for Lisa Graham is 1912886045. It was assigned to this individual provider in the NPPES registry on September 2, 2025.

Where is Lisa Graham located?

Lisa Graham practices at 4218 Burton St SE, Grand Rapids, MI 49546. The listed phone number is (616) 301-8000.

What is Lisa Graham's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Lisa Graham was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.