Individual
BRENDA JANICE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,C
Contact information
Practice address
3107 EASTWICK DR, CLEVELAND HEIGHTS, OH 44118-1222
(216) 371-5253
Mailing address
3107 EASTWICK DR, CLEVELAND HEIGHTS, OH 44118-1222
(216) 371-5253
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN225158
OH
163WG0600X
Gerontology Registered Nurse
—
OH
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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