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Individual

MRS. SARA W WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
950 SANDERS RD, CUMMING, GA 30041-5960
(678) 208-2446
(770) 887-1375
Mailing address
1380 UPPER HEMBREE RD, ROSWELL, GA 30076-1146
(770) 475-2377
(770) 442-0193

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN183641
GA

Other

Enumeration date
01/25/2017
Last updated
10/06/2020
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