SUSAN WALLACE
Nurse Practitioner - Family
Active
Individual
NPI: 1740537687
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner - Family | 363LF0000X | Yes | R852101 (MS) |
Frequently Asked Questions
NPI 1740537687 is the National Provider Identifier for SUSAN WALLACE, a Nurse Practitioner - Family provider located in Hattiesburg, MS. This NPI was enumerated on August 9, 2012.
SUSAN WALLACE practices at 100 METHODIST BLVD, Hattiesburg, MS 39402.
Quick Facts
- NPI
- 1740537687
- Type
- Individual
- Enumerated
- Aug 9, 2012
- Last Updated
- Aug 10, 2012
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