Individual provider · Type 1 NPI
Carrie Leigh Wallace, FNP
Family Nurse Practitioner · Orange, CA
NPI number
1265648596
Active
Practice location
455 S Main St
Orange, CA 92868-3835
Mailing address
19001 Fairhaven Ext
Santa Ana, CA 92705-1359
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 13730 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1265648596
Carrie Leigh Wallace, FNP's National Provider Identifier is 1265648596, issued on May 15, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Orange, CA. The record was last updated on Jul 8, 2007.