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Ms. Susan Ann Wallace
Adult Health Nurse Practitioner in Lutz, Florida
NPI 1104000199

Susan Ann Wallace is an Adult Health Nurse Practitioner based in Lutz, FL and is specialized in Adult Health. Susan Ann Wallace practices in Lutz, FL. The NPI Number for Susan Ann Wallace is 1104000199 and holds a License No. ARNP3262052 (Florida).

The current practice location address for Susan Ann Wallace is 17501 Dale Mabry Hwy N, Lutz, FL and can be reached out via phone at 813-962-1000.

Location: 17501 Dale Mabry Hwy N, Lutz, FL, 33548-4521
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104000199
Provider Name
Susan Ann Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
17501 Dale Mabry Hwy N, Lutz, FL, 33548-4521
Phone Number
813-962-1000
Fax Number
Provider Enumeration Date
12/26/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
17501 Dale Mabry Hwy N
City
Lutz
State
Florida
Zip
33548-4521
Phone Number
813-962-1000
Fax Number
person
Provider Business Mailing Address Details
Address
17501 Dale Mabry Hwy N
City
Lutz
State
Florida
Zip
33548-4521
Phone Number
813-962-1000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
ARNP3262052 (Florida)
Definition
Definition to come...
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