| Doctor Name: | MS. LINDA KAY WALL |
| NPI Number: | 1023072527 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.P.N. |
| License Number: | 209-000339 |
| Business Practice Address: | 318 W Washington St 3rd Floor Bloomington, IL - 617013875 |
| Business Phone Number: | 3098274014 |
| Business Fax Number: | 3098286626 |
| Mailing Address: | 1196 Lynx Ln, NORMAL |
| State: | IL |
| Postal Code: | 617619389 |
| Phone Number: | 3094511628 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2006 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 209-000339 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |