MARTY WALLACE, CRNA
Nurse Anesthetist, Certified Registered
Active
Individual
NPI: 1164674743
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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