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Individual
MS. LEE ANN WALLEN
Active
Individual
MS. LEE ANN WALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
447791-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02635490
—
NY
Enumeration date
07/12/2007
Last updated
07/12/2007
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