Individual provider · Type 1 NPI

Marlyn M. Wallace

Nurse Practitioner · Conyers, GA

NPI number 1144790973 Active

Practice location

3073 Klondike Rd SW
Conyers, GA 30094-5660

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XRN182038 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1144790973

Marlyn M. Wallace's National Provider Identifier is 1144790973, issued on Dec 5, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Conyers, GA. The record was last updated on Dec 5, 2018.