Individual provider · Type 1 NPI
Benjamin Levi Wallace, FNP-C
Family Nurse Practitioner · Huntsville, TX
NPI number
1962913293
Active
Practice location
264 FM 3478 Rd
Huntsville, TX 77320-3322
Mailing address
540 Pine St
Crockett, TX 75835-5555
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | AP134640 (TX) |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1962913293
Benjamin Levi Wallace, FNP-C's National Provider Identifier is 1962913293, issued on Oct 13, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Huntsville, TX. The record was last updated on Oct 13, 2017.