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Individual
DR. JANET NEASE WALLACE
Active
Individual
DR. JANET NEASE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17387
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0046053000
—
WV
05
—
0309964
—
OH
05
—
7100350580
—
KY
Enumeration date
08/24/2005
Last updated
02/18/2025
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