Individual provider · Type 1 NPI

Peggy Lynn Wallace, ARNP

Adult Health Nurse Practitioner · Tampa, FL

NPI number 1285930123 Active

Practice location

4600 N Habana Ave, Suite 15
Tampa, FL 33614-7112

Mailing address

110 W North St
Tampa, FL 33604-6015

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X9274861 (FL)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1285930123

Peggy Lynn Wallace, ARNP's National Provider Identifier is 1285930123, issued on Feb 9, 2011. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Tampa, FL. The record was last updated on May 20, 2011.