DEANNA WALLACE

URBANA, IL
NPI1609222579
Former NameDEANNA BROWN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209014278)
Additional Taxonomies207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: IL  209.014278)
Enumeration Date2016-05-10
Last Update Date2024-12-31
Business Address
DEANNA WALLACE NP
611 W PARK FAPC
URBANA, IL 61802
Phone number: 217-902-6954
Mailing Address
DEANNA WALLACE NP
611 W PARK FAPC
URBANA, IL 61802
Phone number: 217-902-6954