Individual
MRS. KIMBERLY VERONICA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM APRN
Contact information
Practice address
100 LILLIAN GISH BLVD SW STE 201, MASSILLON, OH 44647-6500
(330) 809-0460
Mailing address
3574 MELROSE DR, WOOSTER, OH 44691-1857
(614) 370-1035
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
APRN.CNM.019392
OH
Other
Enumeration date
06/25/2019
Last updated
01/12/2022
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