Individual provider · Type 1 NPI

Rex Michael Wallace, NP

Family Nurse Practitioner · Athens, GA

NPI number 1629960315 Active

Practice location

1061 Dowdy Rd
Athens, GA 30606-5700

Mailing address

964 Mauldin Rd
Jefferson, GA 30549-1308

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XRN286080 (GA)

Family Nurse Practitioner: Definition to come...

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About NPI 1629960315

Rex Michael Wallace, NP's National Provider Identifier is 1629960315, issued on Jul 17, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Athens, GA. The record was last updated on Oct 9, 2025.