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1184976953
KATHRYN JANSEN WALLACE
HUNTERSVILLE, NC
NPI
1184976953
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 5005839)
Enumeration Date
2012-10-04
Last Update Date
2019-05-30
Business Address
KATHRYN JANSEN WALLACE NP
14330 OAKHILL PARK LN STE 200
HUNTERSVILLE, NC 28078-3407
Phone number: 704-316-4830
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Mailing Address
KATHRYN JANSEN WALLACE NP
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone number: 704-316-4830
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