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1245673565
TRESA C WALLACE
GRETNA, LA
NPI
1245673565
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: LA AP07277)
Enumeration Date
2013-04-17
Last Update Date
2020-07-24
Business Address
TRESA C WALLACE WHNP
110 BELLEMEADE BLVD. SUITE A
GRETNA, LA 70056-2954
Phone number: 504-309-2576
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Mailing Address
TRESA C WALLACE WHNP
100 ORANGE BLOSSOM CT
BELLE CHASSE, LA 70037-1649
Phone number: 504-782-0673
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