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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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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