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1275826349
KELLIE L WALLACE
LEXINGTON, KY
NPI
1275826349
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: KY 1077643)
Enumeration Date
2011-05-24
Last Update Date
2011-05-24
Business Address
Ms. KELLIE L WALLACE RN, MSN
1351 NEWTOWN PIKE
LEXINGTON, KY 40511-1275
Phone number: 859-253-1686
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Mailing Address
Ms. KELLIE L WALLACE RN, MSN
1351 NEWTOWN PIKE
LEXINGTON, KY 40511-1275
Phone number: 859-253-1686
Copy
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