MARTY WALLACE, CRNA

Nurse Anesthetist, Certified Registered

Active Individual
NPI: 1164674743

Practice Address

1114 SUNSET DR
SUITE 4
Johnson City, TN 37604

Phone: (423) 283-0776

Specialties

Specialty Code Primary License
Nurse Anesthetist, Certified Registered 367500000X Yes APN13700 (TN)

Frequently Asked Questions

NPI 1164674743 is the National Provider Identifier for MARTY WALLACE, CRNA, a Nurse Anesthetist, Certified Registered provider located in Johnson City, TN. This NPI was enumerated on October 15, 2008.
MARTY WALLACE, CRNA practices at 1114 SUNSET DR, SUITE 4, Johnson City, TN 37604.

Quick Facts

NPI
1164674743
Type
Individual
Enumerated
Oct 15, 2008
Last Updated
Nov 20, 2009

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