Individual
AUNDREA LEIGHANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 MIDLAKE DR UPPR LEVEL, KNOXVILLE, TN 37918-3002
(865) 687-1973
(833) 908-2091
Mailing address
1275 DICK LONAS RD, KNOXVILLE, TN 37909-1382
(865) 584-4747
(865) 381-1509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27443
TN
Other
Enumeration date
04/15/2020
Last updated
11/15/2024
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