person
Mr. Michael Alan Wallace, CNP
Family Nurse Practitioner in Albuquerque, New Mexico
NPI 1003057852

Michael Alan Wallace is a Family Nurse Practitioner based in Albuquerque, NM and is specialized in Family. Michael Alan Wallace practices in Albuquerque, NM and has the professional credentials of CNP. The NPI Number for Michael Alan Wallace is 1003057852 and holds a License No. R48828 (New Mexico).

The current practice location address for Michael Alan Wallace is 8210 Louisiana Blvd Ne, Albuquerque, NM and can be reached out via phone at 505-858-1222 and via fax at 505-858-1224.

Location: 8210 Louisiana Blvd Ne, Albuquerque, NM, 87113-1761
person
Provider Profile Details
NPI Number
1003057852
Provider Name
Michael Alan Wallace
Credential
CNP
Provider Entity Type
Individual
Gender
Male
Address
8210 Louisiana Blvd Ne, Albuquerque, NM, 87113-1761
Phone Number
505-858-1222
Fax Number
505-858-1224
Provider Enumeration Date
03/07/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
29623341 05 NM
institution
Provider Business Practice Location Address Details
Address
8210 Louisiana Blvd Ne
City
State
Zip
87113-1761
Phone Number
505-858-1222
Fax Number
505-858-1224
person
Provider Business Mailing Address Details
Address
8210 Louisiana Blvd Ne
City
State
Zip
87113-1761
Phone Number
505-858-1222
Fax Number
505-858-1224
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R48828 (New Mexico)
Definition
Definition to come...
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