MAGGIE MAE WALLACE

GULF SHORES, AL
NPI1366098642
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AL  1-182953)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: CT  8373)
Enumeration Date2019-08-13
Last Update Date2023-11-13
Business Address
MAGGIE MAE WALLACE
200 OFFICE PARK DR
GULF SHORES, AL 36542-3432
Phone number: 251-968-7379
Mailing Address
MAGGIE MAE WALLACE
200 OFFICE PARK DR
GULF SHORES, AL 36542-3432
Phone number: 512-968-7379