Individual provider · Type 1 NPI

Lisa Wallace, CNP

Acute Care Nurse Practitioner · Greenville, SC

NPI number 1013349000 Active

Practice location

200 Patewood Dr Ste B300
Greenville, SC 29615-6338

Fax (864) 454-4205

Mailing address

300 E Mcbee Ave Fl 4
Greenville, SC 29601-2842

Other practice locations

  • 18101 Lorain Ave, Cleveland, OH 44111-5612 · (216) 476-7000

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner 363LA2100XNP-14866 (OH)
Acute Care Nurse Practitioner Primary 363LA2100X28748 (SC)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1013349000

Lisa Wallace, CNP's National Provider Identifier is 1013349000, issued on Aug 1, 2013. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Greenville, SC. The record was last updated on Sep 13, 2024.