Wallace, Susan Ann
Wallace, Susan Ann is an sole proprietor health care provider with primary practice located at 17501 Dale Mabry Hwy N , Lutz FL 33548-4521. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Wallace, Susan Ann can be contacted via phone (813) 962-1000.Contact Information
Primary practice address
17501 Dale Mabry Hwy N
Lutz FL 33548-4521
Phone: (813) 962-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | ARNP3262052 | Florida |
Profile Details
| NPI number | 1104000199 |
|---|---|
| LBN Legal business name | Wallace, Susan Ann |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 2007 |
| Last updated | Dec 26th, 2007 - 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.
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