Individual provider · Type 1 NPI

Janell Mae Lorton Wallace, PA-C

Surgical Physician Assistant · Duluth, MN

NPI number 1881204360 Active

Practice location

1000 E 1st St Ste 404
Duluth, MN 55805-2297

Call (218) 722-5513 Map

Mailing address

1000 E 1st St, Ste 404
Duluth, MN 55805-2297

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X13693 (MN)
Surgical Physician Assistant Primary 363AS0400X13693 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1881204360

Janell Mae Lorton Wallace, PA-C's National Provider Identifier is 1881204360, issued on Aug 9, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Duluth, MN. The record was last updated on Jul 17, 2024.