SHANNON L WALLACE

INDIANAPOLIS, IN
NPI1851481584
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IN  71001501)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: IN  71001501)
Enumeration Date2006-10-13
Last Update Date2022-09-27
Business Address
SHANNON L WALLACE FNP-BC, PMHNP-BC
1481 W 10TH ST
INDIANAPOLIS, IN 46202-2803
Phone number: 317-554-0000
Mailing Address
SHANNON L WALLACE FNP-BC, PMHNP-BC
12670 N RAINEY RD W
SYRACUSE, IN 46567-9784
Phone number: 317-753-6323