Deanna Wallace, NP

Family Nurse Practitioner · Urbana, IL

Individual Active NPI

NPI number 1609222579

Practice location

611 W Park
Fapc
Urbana, IL 61802
Phone
(217) 902-6954
Fax
(217) 902-7711

Open in Google Maps

NPI record

NPI
1609222579
Entity type
Individual (Type 1)
Enumeration date
May 10, 2016
Last updated
December 31, 2024
Certified
December 30, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Family Nurse Practitioner Primary 363LF0000X 209014278 IL
Cardiovascular Disease Physician 207RC0000X 209.014278 IL

Other practice locations (2)

  • 1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 · (217) 422-6100
  • 1800 E Lake Shore Dr, Decatur, IL 62521-3810 · (217) 422-6100

About Deanna Wallace

Deanna Wallace, NP 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, Fapc, Urbana, IL 61802. The NPI number 1609222579 was assigned on May 10, 2016 and the record was last updated on December 31, 2024.

Deanna Wallace lists 2 licenses in the registry: #209014278 (IL) for Family Nurse Practitioner; #209.014278 (IL) for Cardiovascular Disease Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Deanna Wallace, NP?

The NPI number is 1609222579.

What is the phone number of Deanna Wallace?

The phone number listed for the practice location is (217) 902-6954.

Where is Deanna Wallace located?

611 W Park, Fapc, Urbana, IL 61802.

What is the taxonomy code for Deanna Wallace?

The primary taxonomy code is 363LF0000X – Family Nurse Practitioner; 1 more listed above.

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 →