Individual
DIONNE H WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1900 CLUB MANOR DR STE 105, MAUMELLE, AR 72113-7443
(501) 851-8100
Mailing address
1900 CLUB MANOR DR STE 105, MAUMELLE, AR 72113-7443
(501) 224-1690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005504
AR
Other
Enumeration date
02/09/2018
Last updated
03/04/2025
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