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1962993634
HEATHER ELIZABETH WALLACE
CHARLESTON, SC
NPI
1962993634
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 21745)
Enumeration Date
2018-05-29
Last Update Date
2021-05-26
Business Address
HEATHER ELIZABETH WALLACE NP
1879 SAVAGE RD
CHARLESTON, SC 29407-4726
Phone number: 843-763-9472
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Mailing Address
HEATHER ELIZABETH WALLACE NP
PO BOX 751649
CHARLOTTE, NC 28275-1649
Phone number: 843-789-1620
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