Individual provider · Type 1 NPI

Adam Waller, NP

Nurse Practitioner · West Frankfort, IL

NPI number 1508476615 Active

Practice location

502 W Saint Louis St Ste 4
West Frankfort, IL 62896-1968

Call (618) 937-3400 Map

Fax (618) 997-9324

Mailing address

PO Box 3988
Carbondale, IL 62902-3988

Other practice locations

2601 W Main St, Carbondale, IL 62901-1031 · (618) 549-5361
405 Rushing Dr, Herrin, IL 62948-3730 · (618) 993-3300

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	209021745 (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…

7 other providers at this address

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About NPI 1508476615

Adam Waller, NP's National Provider Identifier is 1508476615, issued on Aug 4, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in West Frankfort, IL. The record was last updated on May 23, 2022.