person
Susan R Wallace
Family Nurse Practitioner in Hattiesburg, Mississippi
NPI 1740537687

Susan R Wallace is a Family Nurse Practitioner based in Hattiesburg, MS and is specialized in Family. Susan R Wallace practices in Hattiesburg, MS. The NPI Number for Susan R Wallace is 1740537687 and holds a License No. R852101 (Mississippi).

The current practice location address for Susan R Wallace is 100 Methodist Blvd, Hattiesburg, MS and can be reached out via phone at 601-268-6738. You can also correspond with Susan R Wallace through the mailing address at 100 METHODIST BLVD, HATTIESBURG, MS - 39402-1295 (mailing address contact number: 601-268-6738).

Location: 100 Methodist Blvd, Hattiesburg, MS, 39402-1295
person
Provider Profile Details
NPI Number
1740537687
Provider Name
Susan R Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
100 Methodist Blvd, Hattiesburg, MS, 39402-1295
Phone Number
601-268-6738
Fax Number
Provider Enumeration Date
08/09/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
100 Methodist Blvd
City
State
Zip
39402-1295
Phone Number
601-268-6738
Fax Number
person
Provider Business Mailing Address Details
Address
100 Methodist Blvd
City
State
Zip
39402-1295
Phone Number
601-268-6738
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R852101 (Mississippi)
Definition
Definition to come...
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