Individual provider · Type 1 NPI
Tashoy M. Wallace, APRN
Adult Health Nurse Practitioner · Orlando, FL
NPI number
1891301164
Active
Practice location
89 W Copeland Dr Fl 2
Orlando, FL 32806-2002
Fax (321) 841-8185
Mailing address
1414 Kuhl Ave # MP38
Orlando, FL 32806-2008
Other practice locations
- 121 Odyssey Turn, Conyers, GA 30012-3681 · (404) 384-8019
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | RN205003 (GA) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | APRN11016381 (FL) |
Adult Health Nurse Practitioner: Definition to come...
4 other providers at this address
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About NPI 1891301164
Tashoy M. Wallace, APRN's National Provider Identifier is 1891301164, issued on Sep 21, 2020. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Orlando, FL. The record was last updated on Jun 25, 2025.