Individual
ASHLEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1440 PICKWICK ST, SAVANNAH, TN 38372-3519
(731) 925-3354
Mailing address
1440 PICKWICK ST, SAVANNAH, TN 38372-3519
(731) 925-3354
(731) 438-3581
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
39722
TN
363LF0000X
Family Nurse Practitioner
Primary
39722
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q107921
—
TN
Enumeration date
05/21/2025
Last updated
04/14/2026
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