Individual provider · Type 1 NPI

Madison Wallace, APN

Family Nurse Practitioner · Covington, TN

NPI number 1740703180 Active

Practice location

1995 Highway 51 S Ste 204
Covington, TN 38019-3655

Call (901) 475-5305 Map

Fax (901) 475-5307

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X22760 (TN)

Family Nurse Practitioner: Definition to come...

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About NPI 1740703180

Madison Wallace, APN's National Provider Identifier is 1740703180, issued on Jul 18, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Covington, TN. The record was last updated on Apr 17, 2024.