Individual
GAIL ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-3925
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-3925
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R096951-0
MN
Other
Enumeration date
10/16/2006
Last updated
04/29/2011
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