location
search-icon
person
Deanna Wallace, NP
Family Nurse Practitioner in Decatur, Illinois
NPI 1609222579

Deanna Wallace is a Family Nurse Practitioner based in Decatur, IL and is specialized in Family. Deanna Wallace practices in Decatur, IL and has the professional credentials of NP. The NPI Number for Deanna Wallace is 1609222579 and holds a License No. 209.014278 (Illinois).

The current practice location address for Deanna Wallace is 1770 E Lake Shore Dr Ste 105, Decatur, IL and can be reached out via phone at 217-422-6100 and via fax at 833-784-5326.

Location: 1770 E Lake Shore Dr Ste 105, Decatur, IL, 62521-3800
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609222579
Provider Name
Deanna Wallace
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1770 E Lake Shore Dr Ste 105, Decatur, IL, 62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
Provider Enumeration Date
05/10/2016
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
P01657319 01 IL RAILROAD
institution
Provider Business Practice Location Address Details
Address
1770 E Lake Shore Dr Ste 105
City
Decatur
State
Illinois
Zip
62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
person
Provider Business Mailing Address Details
Address
1770 E Lake Shore Dr Ste 105
City
Decatur
State
Illinois
Zip
62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
207RC0000X
License No.
209014278 (Illinois)
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209.014278 (Illinois)
Definition
Definition to come...
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.