Individual
MS. LINDA KAY WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.
Contact information
Practice address
318 W WASHINGTON ST, 3RD FLOOR, BLOOMINGTON, IL 61701-3875
(309) 827-4014
(309) 828-6626
Mailing address
1196 LYNX LN, NORMAL, IL 61761-9389
(309) 451-1628
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209-000339
IL
Other
Enumeration date
04/13/2006
Last updated
12/21/2011
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