person
Michael T Wallace, ARNP
Adult Health Nurse Practitioner in Minnetonka, Minnesota
NPI 1194029777

Michael T Wallace is an Adult Health Nurse Practitioner based in Coleman, MN and is specialized in Adult Health. Michael T Wallace practices in Minnetonka, MN and has the professional credentials of ARNP. The NPI Number for Michael T Wallace is 1194029777 and holds a License No. 7139-33 (Minnesota).

The current practice location address for Michael T Wallace is 9900 Bren Rd E, Minnetonka, MN and can be reached out via phone at 352-529-7314.

Location: 9900 Bren Rd E, Minnetonka, MN, 33521-0953
person
Provider Profile Details
NPI Number
1194029777
Provider Name
Michael T Wallace
Credential
ARNP
Provider Entity Type
Individual
Gender
Male
Address
9900 Bren Rd E, Minnetonka, MN, 33521-0953
Phone Number
352-529-7314
Fax Number
Provider Enumeration Date
12/22/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
007980600 05 FL
institution
Provider Business Practice Location Address Details
Address
9900 Bren Rd E
City
State
Zip
55343-9664
Phone Number
352-529-7314
Fax Number
person
Provider Business Mailing Address Details
Address
9900 Bren Rd E
City
State
Zip
55343-9664
Phone Number
352-529-7314
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
7139-33 (Wisconsin)
Definition
Definition to come...
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