person
Tracy Wallace
Administrator Registered Nurse in Detroit, Michigan
NPI 1326481755

Tracy Wallace is an Administrator Registered Nurse based in Detroit, MI and is specialized in Administrator. Tracy Wallace practices in Detroit, MI. The NPI Number for Tracy Wallace is 1326481755 and holds a License No. 4704197701 (Michigan).

The current practice location address for Tracy Wallace is 15400 W Mcnichols Rd, Detroit, MI and can be reached out via phone at 313-732-8272. You can also correspond with Tracy Wallace through the mailing address at 4779 GLENDALE, DETROIT, MI - 48238 (mailing address contact number: ).

Location: 15400 W Mcnichols Rd, Detroit, MI, 48238
person
Provider Profile Details
NPI Number
1326481755
Provider Name
Tracy Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
15400 W Mcnichols Rd, Detroit, MI, 48238
Phone Number
313-732-8272
Fax Number
Provider Enumeration Date
04/16/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
15400 W Mcnichols Rd
City
State
Zip
48235-3724
Phone Number
313-732-8272
Fax Number
person
Provider Business Mailing Address Details
Address
15400 W Mcnichols Rd
City
State
Zip
48235-3724
Phone Number
313-732-8272
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Administrator
Taxonomy
License No.
4704197701 (Michigan)
Definition
Definition to come...
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