STEPHANIE WALLACE, NP
Nurse Practitioner
Active
Individual
NPI: 1124087879
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner - Psychiatric/Mental Health | 363LP0808X | No | RN136273 (GA) |
| Nurse Practitioner - Family | 363LF0000X | No | RN136273 (GA) |
| Nurse Practitioner - Women's Health | 363LW0102X | No | RN136279 (GA) |
| Nurse Practitioner | 363L00000X | Yes | RN136273 (GA) |
Frequently Asked Questions
NPI 1124087879 is the National Provider Identifier for STEPHANIE WALLACE, NP, a Nurse Practitioner provider located in Athens, GA. This NPI was enumerated on March 21, 2006.
STEPHANIE WALLACE, NP practices at 1230 BAXTER ST, Athens, GA 30606.
Quick Facts
- NPI
- 1124087879
- Type
- Individual
- Enumerated
- Mar 21, 2006
- Last Updated
- Oct 31, 2025
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