Individual provider · Type 1 NPI

Kendall E. Wallace, APRN

Family Nurse Practitioner · Urbana, IL

NPI number 1003391061 Active

Practice location

611 W Park St
Urbana, IL 61801-2529

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	209017908 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1003391061

Kendall E. Wallace, APRN's National Provider Identifier is 1003391061, issued on Sep 26, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Urbana, IL. The record was last updated on Apr 4, 2024.