Individual
NARQUINTA LASHAY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4926 W BROAD ST, RICHMOND, VA 23230-3122
(804) 673-5241
(804) 977-6244
Mailing address
2210 WATTS LN, RICHMOND, VA 23223-1939
(804) 833-6579
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002075543
VA
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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