person
Tyler J Wallace, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner in Paducah, Kentucky
NPI 1114700739

Tyler J Wallace is a Psychiatric/Mental Health Nurse Practitioner based in Paducah, KY and is specialized in Psychiatric/Mental Health. Tyler J Wallace practices in Paducah, KY and has the professional credentials of PMHNP-BC. The NPI Number for Tyler J Wallace is 1114700739 and holds a License No. 4005513 (Kentucky).

The current practice location address for Tyler J Wallace is 4570 Pecan Dr Ste C, Paducah, KY and can be reached out via phone at 270-908-3839 and via fax at 270-908-3834. You can also correspond with Tyler J Wallace through the mailing address at 4570 PECAN DR STE C, PADUCAH, KY - 42001-6717 (mailing address contact number: 270-908-3839).

Location: 4570 Pecan Dr Ste C, Paducah, KY, 42001-6717
person
Provider Profile Details
NPI Number
1114700739
Provider Name
Tyler J Wallace
Credential
PMHNP-BC
Provider Entity Type
Individual
Gender
Male
Address
4570 Pecan Dr Ste C, Paducah, KY, 42001-6717
Phone Number
270-908-3839
Fax Number
270-908-3834
Provider Enumeration Date
08/16/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4570 Pecan Dr Ste C
City
State
Zip
42001-6717
Phone Number
270-908-3839
Fax Number
270-908-3834
person
Provider Business Mailing Address Details
Address
4570 Pecan Dr Ste C
City
State
Zip
42001-6717
Phone Number
270-908-3839
Fax Number
270-908-3834
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
4005513 (Kentucky)
Definition
Definition to come...
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