Individual
MS. JANET ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1699 W MOUND ST, COLUMBUS, OH 43223-1809
(614) 263-5006
(614) 263-5019
Mailing address
1129 NORRIS DR, COLUMBUS, OH 43224-2734
(614) 262-7758
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA 05893
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2305811
—
OH
Enumeration date
09/20/2006
Last updated
03/12/2010
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