DEBORAH A WALLACE

LAWRENCEVILLE, GA
NPI1184667388
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: GA  RN040043)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: GA  R040043)
Enumeration Date2006-06-14
Last Update Date2014-04-29
Business Address
-- DEBORAH A WALLACE CRNA
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046-0000
Phone number: 770-277-3056
Mailing Address
-- DEBORAH A WALLACE CRNA
PO BOX 551420
FORT LAUDERDALE, FL 33355-1420
Phone number: 800-243-3839