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1265648596
CARRIE LEIGH WALLACE
ORANGE, CA
NPI
1265648596
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 13730)
Enumeration Date
2007-05-15
Last Update Date
2007-07-08
Business Address
Miss CARRIE LEIGH WALLACE FNP
455 S MAIN ST
ORANGE, CA 92868-3835
Phone number: 714-289-4934
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Mailing Address
Miss CARRIE LEIGH WALLACE FNP
19001 FAIRHAVEN EXT
SANTA ANA, CA 92705-1359
Phone number: 714-633-8187
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