Individual provider · Type 1 NPI

Tyler J. Wallace, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Paducah, KY

NPI number 1114700739 Active

Practice location

1532 Lone Oak Rd Ste 345
Paducah, KY 42003-7942

Fax (270) 538-6596

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X4005513 (KY)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

6 other providers at this address

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About NPI 1114700739

Tyler J. Wallace, PMHNP-BC's National Provider Identifier is 1114700739, issued on Aug 16, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Paducah, KY. The record was last updated on Nov 14, 2024.