SUSAN ANN WALLACE

LUTZ, FL
NPI1104000199
Former NameSUSAN ANN HAYMAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner Adult Health
(Licence: FL  ARNP3262052)
Enumeration Date2007-12-26
Last Update Date2007-12-26
Business Address
MS. SUSAN ANN WALLACE
17501 DALE MABRY HWY N
LUTZ, FL 33548-4521
Phone number: 813-962-1000
Mailing Address
MS. SUSAN ANN WALLACE
17501 DALE MABRY HWY N
LUTZ, FL 33548-4521
Phone number: 813-962-1000
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