Individual
AUDREY JOANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, ENP
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-5750
Mailing address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-5750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP144794
TX
363L00000X
Nurse Practitioner
Primary
AP144794
TX
Other
Enumeration date
01/27/2020
Last updated
07/10/2025
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