# MICHELLE MARIE WALLACE I

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1598884272
- **Gender:** F
- **Credential:** R.N.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | 295117 | OH | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2259041 | — | OH |