Wallace, Dawn L.

Wallace, Dawn L. is an individual health care provider with primary practice located at 18595 Brookridge Dr , Brookfield WI 53045-1026. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Wallace, Dawn L. can be contacted via phone (262) 894-3880.

Contact Information

Primary practice address
18595 Brookridge Dr Brookfield WI 53045-1026
Phone: (262) 894-3880
Fax: (262) 754-0690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin

Profile Details

NPI number 1669421335
LBN Legal business name Wallace, Dawn L.
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669421335 NPPES
Wisconsin MEDICAID 38214700

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