Individual
LAUREN WALLISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
9380 BRADMORE LN, OOLTEWAH, TN 37363-4446
(423) 760-4630
Mailing address
9380 BRADMORE LN, OOLTEWAH, TN 37363-4446
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN276337
GA
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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