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Contact Information

ANGELA D GRAHAM, CPNP-AC
210 W WALNUT ST
CANTON, IL61520-2497
 Phone: 309-647-5240
 Fax: 309-649-5128
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pediatrics, Critical Care

363LP0222X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ANGELA D GRAHAM · (Female)

NPI Number 1902105760
Status Active
Credentials CPNP-AC
Entity Individual
Enumeration date 03/19/2011
Last updated 03/12/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209008727
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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