Individual provider · Type 1 NPI

Grant Wallace

Registered Nurse · Atlanta, GA

NPI number 1336006642 Active

Practice location

1520 Clifton Rd NE Ste 244
Atlanta, GA 30322-4201

Call (404) 727-7980 Map

Mailing address

72 Walthall St SE Unit B
Atlanta, GA 30316-1328

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse Primary 163W00000XRN319027 (GA)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1336006642

Grant Wallace's National Provider Identifier is 1336006642, issued on Jan 7, 2026. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Atlanta, GA. The record was last updated on Jan 7, 2026.