Individual provider · Type 1 NPI
Lisa Ann Wallace
Licensed Practical Nurse · Horton, MI
NPI number
1992368872
Active
Practice location
8700 Mosherville Rd
Horton, MI 49246-9601
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 4703086959 (MI) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
About NPI 1992368872
Lisa Ann Wallace's National Provider Identifier is 1992368872, issued on Apr 17, 2019. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Horton, MI. The record was last updated on Dec 12, 2023.