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1326420530
NATHASA WALLACE
HARVEY, IL
NPI
1326420530
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.012383)
Enumeration Date
2015-06-24
Last Update Date
2024-07-18
Business Address
Ms. NATHASA WALLACE FNP
31 W 155TH ST
HARVEY, IL 60426-3556
Phone number: 708-596-5177
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Mailing Address
Ms. NATHASA WALLACE FNP
31 W 155TH ST
HARVEY, IL 60426-3556
Phone number: 708-596-5177
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