Wallace, Madeline

Wallace, Madeline is an individual health care provider with primary practice located at 2930 11Th Ave , Evans CO 80620-1011. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wallace, Madeline can be contacted via phone (970) 353-9403.

Contact Information

Primary practice address
2930 11Th Ave Evans CO 80620-1011
Phone: (970) 353-9403
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 6761 Colorado

Profile Details

NPI number 1649854456
LBN Legal business name Wallace, Madeline
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2021
Last updated Jun 29th, 2021 - about 3 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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