Wallace, Marlene M.B.
Wallace, Marlene M.B. is an individual health care provider with primary practice located at 5955 Zeamer Ave 673Rd Medical Group/Sghq Dod-Va Joint Venture Hospital, Jber AK 99506-3702. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pain Management, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Wallace, Marlene M.B. can be contacted via phone (907) 580-1035.Contact Information
Primary practice address
5955 Zeamer Ave 673Rd Medical Group/Sghq Dod-Va Joint Venture Hospital
Jber AK 99506-3702
Phone: (907) 580-1035
Fax: (907) 580-3203
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Pain Management | 163WP0000X | 041305554 | Illinois |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 209012095 | Illinois |
Profile Details
NPI number | 1629037676 |
---|---|
LBN Legal business name | Wallace, Marlene M.B. |
Credentials | Certified Registered Nurse Anesthetist (CRNA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 20th, 2006 |
Last updated | Feb 13th, 2023 - 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.
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