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Justin Covey Wallace, RN
Emergency Registered Nurse in Phoenix, Arizona
NPI 1578807103

Justin Covey Wallace is a Emergency Registered Nurse based in Surprise, AZ and is specialized in Emergency. Justin Covey Wallace practices in Phoenix, AZ and has the professional credentials of RN. The NPI Number for Justin Covey Wallace is 1578807103 and holds a License No. RN173423 (Arizona).

The current practice location address for Justin Covey Wallace is 4212 N 16Th St, Phoenix, AZ and can be reached out via phone at 602-263-1200.

Location: 4212 N 16Th St, Phoenix, AZ, 85379-9150
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Provider Profile Details
NPI Number
1578807103
Provider Name
Justin Covey Wallace
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
4212 N 16Th St, Phoenix, AZ, 85379-9150
Phone Number
602-263-1200
Fax Number
Provider Enumeration Date
11/20/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4212 N 16Th St
City
State
Zip
85016-5319
Phone Number
602-263-1200
Fax Number
person
Provider Business Mailing Address Details
Address
4212 N 16Th St
City
State
Zip
85016-5319
Phone Number
602-263-1200
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Emergency
Taxonomy
License No.
RN173423 (Arizona)
Definition
Definition to come...
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