SARA STANIELLE WALLIS

DECATUR, IL
NPI1912760141
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: IL  209029068)
Enumeration Date2024-01-31
Last Update Date2024-01-31
Business Address
SARA STANIELLE WALLIS
2300 N EDWARD ST
DECATUR, IL 62526-4192
Phone number: 217-876-8121
Mailing Address
SARA STANIELLE WALLIS
715 FAIRWAY DR
FORSYTH, IL 62535-9795
Phone number: 217-853-8412