JILL MARIE WALLACE

CHARLOTTE, NC
NPI1598121220
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  19659)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: NC  5008608)
Enumeration Date2016-01-11
Last Update Date2016-09-02
Business Address
Mrs. JILL MARIE WALLACE N.P.
16406 BIRCHLEY CIR
CHARLOTTE, NC 28213-4314
Phone number: 704-258-4240
Mailing Address
Mrs. JILL MARIE WALLACE N.P.
16406 BIRCHLEY CIR
CHARLOTTE, NC 28213-4314
Phone number: 704-258-4240