AMANDA GRAHAM (NPI# 1578112363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578112363 |
| Entity Type | Individual |
| Full Name | AMANDA GRAHAM |
| Credential | FNP-BC |
| Practice Address |
751 N Rutledge St Ste 3100 Springfield IL 62702-4968 |
| Mailing Address |
201 E Madison St Ste 300 Springfield IL 62702-5131 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175457578 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209019551 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336657055 | Amanda Leigh Graham | Counselor | 1453 Big Hill Rd, Pennington Gap, VA 24277-8133 | 2018-01-16 |
| 1023036738 | Amanda J Graham | Counselor | 3622 Lyckan Pkwy Ste 4003, Durham, NC 27707-2566 | 2006-07-18 |
| 1568061448 | Amanda Lynn Graham | Licensed Practical Nurse | 500 Pegasus Ct, Winchester, VA 22602-4596 | 2020-10-21 |
| 1013536291 | Amanda Jean Graham | Behavior Technician | 1025 Atlantic Ave Ste 101, Alameda, CA 94501-1188 | 2020-04-08 |
| 1407487523 | Amanda Graham | Social Worker | 1216 2nd St Sw, Rochester, MN 55902-1906 | 2020-01-28 |
| 1023668605 | Amanda Lee Graham | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2019-09-16 |
| 1386293942 | Amanda Marie Graham | Physical Therapy Assistant | 9425 N Nevada St Ste 100, Spokane, WA 99218-1286 | 2019-09-06 |
| 1174175285 | Amanda Kay Graham | Registered Nurse | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-07-10 |
| 1356877245 | Amanda Jean Graham | Counselor | 216 S Main St, Hobart, OK 73651-3628 | 2017-05-11 |
| 1588033997 | Amanda Graham | Social Worker | 30 Elizabeth St, Derby, CT 06418 | 2015-09-16 |
| Street Address |
751 N RUTLEDGE ST STE 3100 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1912562109 | Katie D Hartman | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2019-05-03 |
| 1528440724 | Jordan Leigh Sestak | Internal Medicine | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2015-06-24 |
| 1174934269 | Charlyn Fargo Ware | Dietitian, Registered | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2014-05-12 |
| 1811322209 | Nicole Lynn Atwood | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2013-09-04 |
| 1184979551 | Bilal Butt | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702 | 2012-07-20 |
| 1043520869 | Jacob M Monsivais | Physician Assistant | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2010-10-14 |
| 1669784559 | Hesham A Allam | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2010-07-08 |
| 1790923951 | Nassir Hassan Monim Mansour | Neurological Surgery | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2009-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072823 | Rachel Westbrook | Nurse Practitioner | 1417 Burning Bush Ct, Springfield, IL 62712-7529 | 2020-10-27 |
| 1730786377 | Catherine Newman | Nurse Practitioner | 27124 La-42, Springfield, LA 70462 | 2020-10-07 |
| 1275146268 | Courtney Wilbern | Nurse Practitioner | 1200 W Centre St, Springfield, IL 62704-5812 | 2020-08-28 |
| 1588276240 | Andrew Ronald Mouser | Nurse Practitioner | 607 Prospect Rd, Springfield, PA 19064-2819 | 2020-08-23 |
| 1821609082 | William Coleman Bryant | Nurse Practitioner | 5552 W Longleaf Dr, Springfield, MO 65802-7834 | 2020-08-12 |
| 1386254399 | Ashley Lynn Murray | Nurse Practitioner | 2443 E Greenwood St, Springfield, MO 65804-3907 | 2020-08-04 |
| 1679182281 | Erica Gail Hunt | Nurse Practitioner | 2813 Haverford Rd, Springfield, IL 62704-4267 | 2020-07-29 |
| 1063020063 | Gage Azeez | Nurse Practitioner | 46 Timber Ln, Springfield, MA 01119-2828 | 2020-07-16 |
| 1033737440 | Janne L Nicholson | Nurse Practitioner | 8360 Dunham Ct Apt G, Springfield, VA 22152-1122 | 2020-07-13 |
| 1922623156 | Amanda E Hildebrand | Nurse Practitioner | 3370 Carman Ave, Springfield, IL 62703-4642 | 2020-06-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on AMANDA GRAHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.