Individual provider · Type 1 NPI
Ashley Lynette Wallace, MSN, APRN, FNP-C
Primary Care Nurse Practitioner · Fort Worth, TX
NPI number
1679133573
Active
Practice location
1400 8th Ave
Fort Worth, TX 76104-4110
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | AP141896 (TX) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | PENDING (TX) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1679133573
Ashley Lynette Wallace, MSN, APRN, FNP-C's National Provider Identifier is 1679133573, issued on Jun 13, 2019. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fort Worth, TX. The record was last updated on Apr 7, 2020.