Wallace, Heather E

Wallace, Heather E is an individual health care provider with primary practice located at 535 Coliseum Dr , Macon GA 31217-0104. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Wallace, Heather E can be contacted via phone (478) 972-0277.

Contact Information

Primary practice address
535 Coliseum Dr Macon GA 31217-0104
Phone: (478) 972-0277
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN197918 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN197918 Georgia

Profile Details

NPI number 1053856427
LBN Legal business name Wallace, Heather E
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2016
Last updated Dec 27th, 2016 - about 9 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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