Waller, Adam

Waller, Adam is an sole proprietor health care provider with primary practice located at 502 W Saint Louis St Ste 4 , West Frankfort IL 62896-1968. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Waller, Adam can be contacted via phone (618) 937-3400.

Contact Information

Primary practice address
502 W Saint Louis St Ste 4 West Frankfort IL 62896-1968
Phone: (618) 937-3400
Fax: (618) 997-9324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209021745 Illinois

Profile Details

NPI number 1508476615
LBN Legal business name Waller, Adam
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2020
Last updated May 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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