SHANNON D WALLE

SPRINGFIELD, IL
NPI1649883992
Former NameSHANNON D WAGGONER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209021729)
Enumeration Date2020-08-26
Last Update Date2024-11-08
Business Address
SHANNON D WALLE FNP-BC
800 N 1ST ST
SPRINGFIELD, IL 62702-3778
Phone number: 217-528-7541
Mailing Address
SHANNON D WALLE FNP-BC
PO BOX 19248
SPRINGFIELD, IL 62794-9248
Phone number:
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