DR. Dane C Wallace, NURSE PRACTITIONER is a family nurse practitioner in Edwardsville, IL with 2 years of experience. DR. Dane C Wallace, NURSE PRACTITIONER NPI is 1528787744. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
529 HILLSBORO AVE
EDWARDSVILLE, IL
ZIP 62025-864
Phone: (217) 621-8675
The NPI 1528787744 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 8/22/2022 and was last updated on 11/6/2023.