| NPI | 1639351018 |
|---|---|
| Former Name | REBECCA ANNE WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 0050-03734) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 4120) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 0050-03734) | |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2021-08-13 |