Individual provider · Type 1 NPI
Lizabeth Wallace
Nurse Practitioner · Peoria, IL
Practice location
420 NE Glen Oak Ave
Peoria, IL 61603-3105
Fax (309) 655-3948
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 0411285741-209004409 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1417019084
Lizabeth Wallace's National Provider Identifier is 1417019084, issued on Dec 13, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Peoria, IL. The record was last updated on Apr 20, 2009.