Individual provider · Type 1 NPI

Donna C. Wallace, PNP

Pediatric Nurse Practitioner · Phoenix, AZ

NPI number 1346236122 Active

Practice location

2910 N 3rd Ave
Phoenix, AZ 85013-4434

Fax (602) 406-6126

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XRN041572 (AZ)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1346236122

Donna C. Wallace, PNP's National Provider Identifier is 1346236122, issued on Sep 27, 2005. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Phoenix, AZ. The record was last updated on Sep 3, 2014.