Wallace, Kimberly Lane

Wallace, Kimberly Lane is an individual health care provider with primary practice located at 3535 Pentagon Blvd , Beavercreek OH 45431-1705. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Wallace, Kimberly Lane can be contacted via phone (937) 702-4000.

Contact Information

Primary practice address
3535 Pentagon Blvd Beavercreek OH 45431-1705
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X APRN.CNP.0032777 Ohio

Profile Details

NPI number 1619688116
LBN Legal business name Wallace, Kimberly Lane
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2022
Last updated Dec 6th, 2022 - about 2 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.

Request for update

Popular Providers