Individual
DONNA J WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
W.H.N.P.
Contact information
Practice address
145 INNOVATION DR, JACKSON, TN 38305-3019
(731) 422-0213
(731) 660-8301
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-5752
(731) 425-5783
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
APN12122
TN
Other
Enumeration date
07/24/2006
Last updated
10/25/2023
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