ANDREA NICOLE WALLACE

CHARLOTTE, NC
NPI1417455809
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NC  5010264)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: NC  5010264)
Enumeration Date2018-01-31
Last Update Date2023-12-18
Business Address
ANDREA NICOLE WALLACE FNP
14214 BALLANTYNE LAKE RD STE 100
CHARLOTTE, NC 28277-3372
Phone number: 704-667-2650
Mailing Address
ANDREA NICOLE WALLACE FNP
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number: