Individual provider · Type 1 NPI

Bonnie Wallace, ANP-BC

Adult Health Nurse Practitioner · Brentwood, TN

NPI number 1770844300 Active

Practice location

5410 Maryland Way Ste 400
Brentwood, TN 37027-8087

Fax (629) 240-6003

Other practice locations

  • 4230 Harding Pike, Ste 330, Nashville, TN 37205-2013 · (615) 269-4545

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XAPN0000016620 (TN)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1770844300

Bonnie Wallace, ANP-BC's National Provider Identifier is 1770844300, issued on May 30, 2012. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Brentwood, TN. The record was last updated on Oct 26, 2026.