Individual
MS. MICHELLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8350 E KEMPER RD STE A, CINCINNATI, OH 45249-1684
(513) 404-4166
Mailing address
8350 E KEMPER RD STE A, CINCINNATI, OH 45249-1684
(513) 404-4166
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP-07879
OH
Other
Enumeration date
03/05/2007
Last updated
03/22/2022
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