person
Kimberly Lane Wallace, NP-C
Primary Care Nurse Practitioner in Beavercreek, Ohio
NPI 1619688116

Kimberly Lane Wallace is a Primary Care Nurse Practitioner based in Brookville, OH and is specialized in Primary Care. Kimberly Lane Wallace practices in Beavercreek, OH and has the professional credentials of NP-C. The NPI Number for Kimberly Lane Wallace is 1619688116 and holds a License No. APRN.CNP.0032777 (Ohio).

The current practice location address for Kimberly Lane Wallace is 3535 Pentagon Blvd, Beavercreek, OH and can be reached out via phone at 937-702-4000.

Location: 3535 Pentagon Blvd, Beavercreek, OH, 45309-8225
person
Provider Profile Details
NPI Number
1619688116
Provider Name
Kimberly Lane Wallace
Credential
NP-C
Provider Entity Type
Individual
Gender
Female
Address
3535 Pentagon Blvd, Beavercreek, OH, 45309-8225
Phone Number
937-702-4000
Fax Number
Provider Enumeration Date
12/06/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3535 Pentagon Blvd
City
State
Zip
45431-1705
Phone Number
937-702-4000
Fax Number
person
Provider Business Mailing Address Details
Address
3535 Pentagon Blvd
City
State
Zip
45431-1705
Phone Number
937-702-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
APRN.CNP.0032777 (Ohio)
Definition
Definition to come...
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