Individual
MEGAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 862-2432
(513) 862-8857
Mailing address
PO BOX 638431, CINCINNATI, OH 45263-8431
(717) 263-5562
(717) 263-1566
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.343875-COA1
OH
Other
Enumeration date
12/30/2014
Last updated
01/02/2015
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