Lizabeth Wallace
Lizabeth Wallace is a Nurse Practitioner in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.
- Licensed in
- IL
- In the registry since
- 2006
Practice location Address checks out
420 NE Glen Oak AvePeoria, IL 61603-3105
Phone: (309) 655-2343
Fax: (309) 655-3948
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 0411285741-209004409 (IL) |
|---|
Record details
| NPI number | 1417019084 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | December 13, 2006 |
| Last updated in NPPES | April 20, 2009 |
| Mailing address | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 |
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