Individual
PATRICIA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1251
Mailing address
11802 APACHE AVE NE, ALBUQUERQUE, NM 87112-3471
(505) 453-7667
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
RN-88042
NM
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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