Individual
SARAH JANE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
4820 N OAK TRFY, KANSAS CITY, MO 64118-4691
(816) 853-8657
Mailing address
701 4TH ST, PLATTE CITY, MO 64079-8458
(816) 853-8657
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2018039449
MO
363LF0000X
Family Nurse Practitioner
Primary
78450
KS
Other
Enumeration date
12/11/2018
Last updated
01/17/2022
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