Individual provider · Type 1 NPI
Susan Ann Wallace
Adult Health Nurse Practitioner · Lutz, FL
NPI number
1104000199
Active
Practice location
17501 Dale Mabry Hwy N
Lutz, FL 33548-4521
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | ARNP3262052 (FL) |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
Other adult health nurse practitioner providers in Lutz
- Sheryl Diane Fagan, A.R.N.P.Adult Health Nurse Practitioner Lutz, FL NPI 1295055242
- Anthony Scott Casinger, ARNPAdult Health Nurse Practitioner Lutz, FL NPI 1427497783
- Amy Maria Reid, A.R.N.P.Adult Health Nurse Practitioner Lutz, FL NPI 1598004715
- Steven Mark Fountain, ARNPAdult Health Nurse Practitioner Lutz, FL NPI 1689898348
- Jennifer F. Harbour, APRNAdult Health Nurse Practitioner Lutz, FL NPI 1902449663
About NPI 1104000199
Susan Ann Wallace's National Provider Identifier is 1104000199, issued on Dec 26, 2007. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Lutz, FL. The record was last updated on Dec 26, 2007.