Individual
JOHN WALLACE
Active
Individual
JOHN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
10406-33
WI
367500000X
Certified Registered Nurse Anesthetist
209021371
IL
367500000X
Certified Registered Nurse Anesthetist
2355
MN
367500000X
Certified Registered Nurse Anesthetist
AP61248892
WA
367500000X
Certified Registered Nurse Anesthetist
APN.0996269-CRNA
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA 01415
NM
Other
Enumeration date
02/18/2016
Last updated
05/11/2022
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