NPI Profile for AMY M WALLACE in LEXINGTON, KY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Neonatal |
363LN0000X | 50 | Nurse Practitioner | |
Neonatal, Critical Care |
363LN0005X | 50 | Nurse Practitioner |
| NPI Number | 1104178052 |
|
| Status | Active | |
| Credentials | APRN, NNP-BC | |
| Entity | Individual | |
| Enumeration date | 10/02/2012 | |
| Last updated | 06/06/2024 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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AMY M WALLACE
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