STEPHANIE R WALLACE

ATHENS, GA
NPI1124087879
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN136273)
Enumeration Date2006-03-21
Last Update Date2024-01-15
Business Address
STEPHANIE R WALLACE NP
1230 BAXTER ST
ATHENS, GA 30606-3712
Phone number: 706-389-2273
Mailing Address
STEPHANIE R WALLACE NP
PO BOX 48089
ATHENS, GA 30604-8089
Phone number: 706-389-3740