Individual
MRS. ILENE WALLMUELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2312 N NEVADA AVE STE 235, COLORADO SPRINGS, CO 80907-5312
(719) 571-8840
(719) 571-8845
Mailing address
2312 N NEVADA AVE STE 235, COLORADO SPRINGS, CO 80907-5312
(719) 571-8840
(719) 571-8845
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0993189-NP
CO
363L00000X
Nurse Practitioner
ARNP748022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303423200
—
FL
Enumeration date
08/11/2005
Last updated
11/20/2017
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