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Contact Information

CARRIE M WALLACE, LPN
472 PIKE STREET
MARIETTA, OH45750
 Phone: 740-236-4452
 Fax: 740-236-4453
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for CARRIE M WALLACE · (Female)

NPI # 1306518089
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 10/01/2021
Last updated 10/01/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 115406
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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