LESHONDA TEQUILLA WALLACE

WILMINGTON, NC
NPI1851403257
Former NameLESHONDA T WALLACE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NC  5006194)
Enumeration Date2006-08-31
Last Update Date2021-05-27
Business Address
LESHONDA TEQUILLA WALLACE FNP
1725 NEW HANOVER MEDICAL PARK DR
WILMINGTON, NC 28403-5345
Phone number: 910-662-9300
Mailing Address
LESHONDA TEQUILLA WALLACE FNP
PO BOX 936857
ATLANTA, GA 31193-6857
Phone number:
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