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MRS. KANDACE MARIE WALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1792 ALYSHEBA WAY, SUITE 150, LEXINGTON, KY 40509-2288
(859) 335-9041
Mailing address
3851 DYLAN PL, LEXINGTON, KY 40514-1062
(606) 669-8601

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007996
KY

Other

Enumeration date
03/21/2013
Last updated
02/09/2015
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