Deanna Wallace

NP | Nurse Practitioner | 8+ years Exp

1770 E Lake Shore Dr Ste 105, Decatur
  Illinois, 62521-3800
217-422-6100
Accepts Medicare Nurse Anesthetist in Decatur, Illinois.
Deanna Wallace is a Decatur, Illinois based nurse practitioner with 8 years of experience in . She completed her graduation in 2016. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Deanna Wallace is 209014278 for Family in Illinois. Her current practice location is 1770 E Lake Shore Dr Ste 105, Decatur. Patients can reach her at 217-422-6100 or can fax her at 833-784-5326. Deanna Wallace is NP and her NPI number (Unique professional ID assigned by NPPES) is 1609222579.
Deanna Wallace has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Deanna Wallace speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for appointment.
Name: Deanna Wallace
Specialization: Nurse Practitioner (NP)
Gender:Female
Credentials: NP
Experience: 8+ years
Medical School Attended:Other
Graduation Year:2016
Accepts Medicare Assignment:Yes
Practice Address:1770 E Lake Shore Dr Ste 105, Decatur,
Illinois, 62521-3800
Phone:217-422-6100
Fax:833-784-5326
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
PAC ID: 5799074605
Enrollment ID: I20160517000849
NPI Number: 1609222579
NPI Enumeration Date: 10 May, 2016
NPI Last Update On: 27 Dec, 2021

Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Deanna Wallace are as mentioned below.
License NumberSpecializationStateStatus
209014278Family IllinoisPrimary
209.014278Internal Medicine IllinoisSecondary
Hospital Affiliation:
NPs can be affiliated to many hospitals whom they worked with in the past or are presently working with. One NP can be affiliated to four to five hospitals at a time.
Hospital Name (CCN) State Hospital Type
(140166)Decatur, ILAcute Care Hospital
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name with which Deanna Wallace is associated with along with the number of members in that group.
Organization Name (Group PAC ID) Members
Prairie Cardiovascular Consultants Ltd (3173435880)96
Other Medical Identifiers:
Other legacy medical identifiers associated with Deanna Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
P01657319OtherIllinoisRAILROAD
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Deanna Wallace
1770 E Lake Shore Dr Ste 105,
Decatur, Illinois
Zip: 62521-3800
Phone Number: 217-422-6100
Fax Number: 833-784-5326
Patients can reach Deanna Wallace at 1770 E Lake Shore Dr Ste 105, Decatur, Illinois or can call to book an appointment on 217-422-6100.
Comments/ Reviews:

Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.