Individual
MRS. STEPHANIE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, FNP-C
Contact information
Practice address
1290 7TH ST STE 8, SLIDELL, LA 70458-2042
(985) 251-2562
Mailing address
1290 7TH ST STE 8, SLIDELL, LA 70458-2042
(985) 251-2562
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
237784
LA
Other
Enumeration date
10/01/2024
Last updated
10/29/2025
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