Individual provider · Type 1 NPI

Brandy S. Wallace

Family Nurse Practitioner · New Orleans, LA

NPI number 1770113441 Active

Practice location

6823 Saint Charles Ave Bldg 92
New Orleans, LA 70118-5665

Mailing address

41 County Road 127
Quitman, MS 39355-9668

Other practice locations

  • 41 County Road 127, Quitman, MS 39355-9668 · (601) 616-1864

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X903712 (MS)
Family Nurse Practitioner Primary 363LF0000X215880 (LA)

Family Nurse Practitioner: Definition to come...

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About NPI 1770113441

Brandy S. Wallace's National Provider Identifier is 1770113441, issued on Jan 22, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New Orleans, LA. The record was last updated on Oct 12, 2020.