KIMBERLY LANE WALLACE

BEAVERCREEK, OH
NPI1619688116
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: OH  APRN.CNP.0032777)
Enumeration Date2022-12-06
Last Update Date2022-12-06
Business Address
KIMBERLY LANE WALLACE NP-C
3535 PENTAGON BLVD
BEAVERCREEK, OH 45431-1705
Phone number: 937-702-4000
Mailing Address
KIMBERLY LANE WALLACE NP-C
935 SALEM ST
BROOKVILLE, OH 45309-8225
Phone number: 937-344-5173
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