Individual
MRS. CHRISTINE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, ACNS-BC
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 286-3576
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.312141-COA1
OH
364SA2200X
Adult Health Clinical Nurse Specialist
COA.15471-NS
OH
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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