Wallace, Marlene T

Wallace, Marlene T is an individual health care provider with primary practice located at 1142 N Broome St , Waxhaw NC 28173-9378. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wallace, Marlene T can be contacted via phone (704) 843-4680.

Contact Information

Primary practice address
1142 N Broome St Waxhaw NC 28173-9378
Phone: (704) 843-4680
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201319 North Carolina

Profile Details

NPI number 1780665521
LBN Legal business name Wallace, Marlene T
Credentials RN, FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Jun 16th, 2009 - about 17 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