Individual
ASHLEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
152 COUNTY ROAD 143, OXFORD, MS 38655-8663
(662) 202-7494
(662) 202-7494
Mailing address
152 COUNTY ROAD 143, OXFORD, MS 38655-8663
(662) 202-7494
(662) 202-7494
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
910290
MS
Other
Enumeration date
12/19/2025
Last updated
12/19/2025
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