Individual provider · Type 1 NPI

Amanda Gail Wallace

Family Nurse Practitioner · West Union, OH

NPI number 1154844041 Active

Practice location

247 Cic Blvd
West Union, OH 45693-7512

Fax (513) 694-0168

Mailing address

6460 Harrison Ave Ste 200
Cincinnati, OH 45247-7958

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X3011658 (KY)
Family Nurse Practitioner Primary 363LF0000XAPRN.CNP.021126 (OH)
Registered Nurse 163W00000XRN.300987 (OH)
Registered Nurse 163W00000X1155351 (KY)

Family Nurse Practitioner: Definition to come...

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About NPI 1154844041

Amanda Gail Wallace's National Provider Identifier is 1154844041, issued on Jul 21, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in West Union, OH. The record was last updated on May 5, 2023.