Individual
SABRINA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9257 NE 83RD TERRANCE, KANSAS CITY, MO 64158
(816) 407-9797
Mailing address
9257 NE 83RD TER, KANSAS CITY, MO 64158-7155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1041733
TX
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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