Individual
MRS. AMY M WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NNP-BC
Contact information
Practice address
800 ROSE ST FL 4, LEXINGTON, KY 40536-0001
(859) 218-2581
(859) 257-1632
Mailing address
800 ROSE ST, 4TH FLOOR, LEXINGTON, KY 40536-0001
(859) 323-0101
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
3007721
KY
363LN0005X
Critical Care Neonatal Nurse Practitioner
3007721
KY
Other
Enumeration date
10/02/2012
Last updated
06/06/2024
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