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Individual
HAROLYN WALLACE
Active
Individual
HAROLYN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
600813
TX
363LF0000X
Family Nurse Practitioner
Primary
AP122716
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320242601
—
TX
01
—
8396NA
BCBS
TX
Enumeration date
03/29/2013
Last updated
11/19/2024
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