Kendall E. Wallace, APRN

Family Nurse Practitioner · Urbana, IL

Individual Active NPI

NPI number 1003391061

Practice location

611 W Park St
Urbana, IL 61801-2529
Phone
(217) 383-3311

Open in Google Maps

NPI record

NPI
1003391061
Entity type
Individual (Type 1)
Enumeration date
September 26, 2018
Last updated
April 4, 2024
Certified
April 4, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Family Nurse Practitioner Primary 363LF0000X 209017908 IL

Mailing address

611 W Park St
Urbana, IL 61801-2501

About Kendall Wallace

Kendall E. Wallace, APRN is a healthcare provider registered in the NPI registry with the primary taxonomy Family Nurse Practitioner (code 363LF0000X). The practice location is 611 W Park St, Urbana, IL 61801-2529. The NPI number 1003391061 was assigned on September 26, 2018 and the record was last updated on April 4, 2024.

Kendall Wallace lists a license in the registry: #209017908 (IL) for Family Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kendall E. Wallace, APRN?

The NPI number is 1003391061.

What is the phone number of Kendall Wallace?

The phone number listed for the practice location is (217) 383-3311.

Where is Kendall Wallace located?

611 W Park St, Urbana, IL 61801-2529.

What is the taxonomy code for Kendall Wallace?

The primary taxonomy code is 363LF0000X – Family Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Family Nurse Practitioner providers in Urbana

All Family Nurse Practitioner providers in Urbana, IL →