Provider Demographics
NPI:1922566777
Name:APPLEMAN GRAHAM, BARBARA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:APPLEMAN GRAHAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 E US ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-5003
Mailing Address - Country:US
Mailing Address - Phone:217-876-5320
Mailing Address - Fax:217-876-5865
Practice Address - Street 1:4455 E US ROUTE 36
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-5003
Practice Address - Country:US
Practice Address - Phone:217-876-5320
Practice Address - Fax:217-876-5865
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019003600363LF0000X
IL209020996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041492519OtherRN LICENSE