Provider Demographics
NPI:1487135836
Name:ISBELL-GRAHAM, ANITA M (APRN)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:ISBELL-GRAHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5367
Mailing Address - Country:US
Mailing Address - Phone:620-342-4864
Mailing Address - Fax:620-343-3545
Practice Address - Street 1:420 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801
Practice Address - Country:US
Practice Address - Phone:620-342-4864
Practice Address - Fax:620-343-3545
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily