Individual
MRS. QUINCY JADE WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
901 S MAIN ST, OTTAWA, KS 66067-3315
(857) 229-8882
Mailing address
901 S MAIN ST, OTTAWA, KS 66067-3315
(857) 229-8882
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
81556
KS
Other
Enumeration date
11/21/2022
Last updated
04/30/2024
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