Wallace, Shereece Nichole

Wallace, Shereece Nichole is an individual health care provider with primary practice located at 4500 Memorial Dr , Belleville IL 62226-5360. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Wallace, Shereece Nichole can be contacted via phone (618) 257-6220.

Contact Information

Primary practice address
4500 Memorial Dr Belleville IL 62226-5360
Phone: (618) 257-6220
Fax: (618) 257-6679
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2017038282 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209017027 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209017027 Illinois

Profile Details

NPI number 1104338318
LBN Legal business name Wallace, Shereece Nichole
Credentials DNP, AGPCNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2017
Last updated Mar 28th, 2024 - about last year

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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