Individual provider · Type 1 NPI

Michael Alan Wallace, CNP

Family Nurse Practitioner · Albuquerque, NM

NPI number 1003057852 Active

Practice location

8210 Louisiana Blvd NE, Suite C
Albuquerque, NM 87113-1761

Call (505) 858-1222 Map

Fax (505) 858-1224

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XR48828 (NM)

Family Nurse Practitioner: Definition to come...

2 other providers at this address

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About NPI 1003057852

Michael Alan Wallace, CNP's National Provider Identifier is 1003057852, issued on Mar 7, 2009. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Albuquerque, NM. The record was last updated on Mar 11, 2013.