Individual
MEREDITH ELISE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 440-2200
Mailing address
3102 WHEATON DR, AVON, OH 44011-5731
(419) 545-0276
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
022622
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022622
CNP
OH
Enumeration date
04/27/2018
Last updated
04/27/2018
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