NPI 1003391061

Kendall E Wallace, APRN

Practitioner Family Nurse Practitioner Urbana, IL

Practice location

Address: 611 W Park St, Urbana, IL 61801-2529
Phone: (217) 383-3311
Mailing address: 611 W Park St, Urbana, IL 61801-2501

Registered specialties

Family Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence 209017908 (IL)

Other Nurse Practitioner providers in Illinois →

Registry record

NPI: 1003391061
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2018
Record last updated: 4 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.