SHANNON D WALLE

DECATUR, 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 Date2024-04-26
Business Address
SHANNON D WALLE FNP-BC
3131 N WATER ST
DECATUR, IL 62526-2472
Phone number: 217-876-5320
Mailing Address
SHANNON D WALLE FNP-BC
3131 N WATER ST
DECATUR, IL 62526-2472
Phone number:
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