Individual
HAILEY D WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
930 BETHEL RD, COLUMBUS, OH 43214-1906
(614) 451-0500
Mailing address
750 CROSS POINTE RD STE C, GAHANNA, OH 43230-6692
(614) 761-1255
(614) 552-0168
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA.019718
OH
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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