Individual
AMY M WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
7777 W 38TH AVE, SUITE 130, WHEAT RIDGE, CO 80033-6168
(720) 418-8182
Mailing address
590 NEW WAVERLY PL, 210, CARY, NC 27518-7407
(720) 418-8186
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
101447
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07014475
—
CO
Enumeration date
06/26/2006
Last updated
11/19/2015
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