Mallory R. Waltrip, APRN

Gerontology Nurse Practitioner · Springfield, IL

Individual Active NPI

NPI number 1780125278

Practice location

900 N 1st St
Springfield, IL 62702-3749
Phone
(217) 528-7541

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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

TaxonomyCodeLicenseState
Gerontology Nurse Practitioner Primary 363LG0600X 209015762 IL
Adult Health Nurse Practitioner 363LA2200X 209015762 IL

Mailing address

1025 S 6TH St
Springfield, 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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