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Mallory Lynn Bacon
Student in an Organized Health Care Education/Training Program in Lincoln, Illinois
NPI 1669910097

Mallory Lynn Bacon is a Student in an Organized Health Care Education/Training Program based in Lincoln, IL. Mallory Lynn Bacon practices in Lincoln, IL. The NPI Number for Mallory Lynn Bacon is 1669910097 and holds a License No. (Illinois).

The current practice location address for Mallory Lynn Bacon is 822 Pulaski St, Lincoln, IL and can be reached out via phone at 217-871-9181.

Location: 822 Pulaski St, Lincoln, IL, 62656-2902
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669910097
Provider Name
Mallory Lynn Bacon
Credential
Provider Entity Type
Individual
Gender
Female
Address
822 Pulaski St, Lincoln, IL, 62656-2902
Phone Number
217-871-9181
Fax Number
Provider Enumeration Date
02/06/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
822 Pulaski St
City
Lincoln
State
Illinois
Zip
62656-2902
Phone Number
217-871-9181
Fax Number
person
Provider Business Mailing Address Details
Address
822 Pulaski St
City
Lincoln
State
Illinois
Zip
62656-2902
Phone Number
217-871-9181
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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