Mallory R. Waltrip, APRN
Gerontology Nurse Practitioner · Springfield, IL
Practice location
900 N 1st StSpringfield, IL 62702-3749
- Phone
- (217) 528-7541
NPI record
- NPI
- 1780125278
- Entity type
- Individual (Type 1)
- Enumeration date
- March 16, 2017
- Last updated
- April 7, 2026
- Certified
- April 7, 2026
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X |
209015762 | IL |
| Adult Health Nurse Practitioner | 363LA2200X |
209015762 | IL |
Mailing address
1025 S 6TH StSpringfield, IL 62703-2403
- Phone
- (217) 528-7541
About Mallory Waltrip
Mallory R. Waltrip, APRN is a healthcare provider registered in the NPI registry with the primary taxonomy Gerontology Nurse Practitioner (code 363LG0600X). The practice location is 900 N 1st St, Springfield, IL 62702-3749. The NPI number 1780125278 was assigned on March 16, 2017 and the record was last updated on April 7, 2026.
Mallory Waltrip lists 2 licenses in the registry: #209015762 (IL) for Gerontology Nurse Practitioner; #209015762 (IL) for Adult Health 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 Mallory R. Waltrip, APRN?
The NPI number is 1780125278.
What is the phone number of Mallory Waltrip?
The phone number listed for the practice location is (217) 528-7541.
Where is Mallory Waltrip located?
900 N 1st St, Springfield, IL 62702-3749.
What is the taxonomy code for Mallory Waltrip?
The primary taxonomy code is 363LG0600X – Gerontology 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.
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