KELLY ELIZABETH WALLACE

PETERSBURG, VA
NPI1417609694
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: VA  0024183547)
Enumeration Date2022-01-19
Last Update Date2022-01-27
Business Address
KELLY ELIZABETH WALLACE NP
200 MEDICAL PARK BLVD
PETERSBURG, VA 23805-9274
Phone number: 804-765-5000
Mailing Address
KELLY ELIZABETH WALLACE NP
2610 SETTING SUN DR
POWHATAN, VA 23139-7552
Phone number: 910-443-1679
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