Individual
BRITTNEY A WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 293-8228
(937) 293-8229
Mailing address
PO BOX 932759, CLEVELAND, OH 44193-0015
(800) 731-0751
(317) 614-9817
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024170589
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.16674
OH
Other
Enumeration date
02/12/2013
Last updated
12/02/2019
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