Mrs Angela D Graham, CPNP-AC | |
210 W Walnut St, Canton, IL 61520-2497 | |
(309) 647-5240 | |
(309) 649-5128 |
Full Name | Mrs Angela D Graham |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 210 W Walnut St, Canton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902105760 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0222X | Nurse Practitioner - Pediatrics, Critical Care | 209008727 (Illinois) | Secondary |
363L00000X | Nurse Practitioner | 209008727 (Illinois) | Primary |
Entity Name | Graham Hospital Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780692087 PECOS PAC ID: 2769375021 Enrollment ID: O20040510000873 |
Mailing Address | Practice Location Address |
---|---|
Mrs Angela D Graham, CPNP-AC 210 W Walnut St, Canton, IL 61520-2497 Ph: (309) 647-5240 | Mrs Angela D Graham, CPNP-AC 210 W Walnut St, Canton, IL 61520-2497 Ph: (309) 647-5240 |
Ms. Dara Marie Wagner, APN-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 | |
Tracy Ann Iversen, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 210 W Walnut St, Canton, IL 61520 Phone: 309-647-0201 | |
Jessica Lynn Bugos, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 | |
Cody J. Gibbs, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-649-6880 | |
Stephanie Barnes, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-649-6880 | |
Theresa Bankert, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 700 E Oak St, Canton, IL 61520 Phone: 309-647-1134 | |
Carley Elizabeth Promisson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 126 N 5th Ave, Canton, IL 61520 Phone: 309-647-0201 |