Individual
MRS. JULIANN MARIA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
840 E 22ND ST, YUMA, AZ 85365-2425
(928) 782-9241
Mailing address
11391 S VIEWPOINTE WAY, YUMA, AZ 85367-6811
(928) 342-7374
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN143698
AZ
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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