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MS. CAMILLE ANNE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
404 ZENA RD STE 1, WOODSTOCK, NY 12498-2627
(845) 679-5271
Mailing address
45 BIRCH ST APT 18K, KINGSTON, NY 12401-1077
(845) 489-1073

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
354716
NY

Other

Enumeration date
06/05/2024
Last updated
07/04/2024
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