Individual
MS. BETH IRENE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4354 NW 23RD AVE # AVW, GAINESVILLE, FL 32606-6541
(352) 376-4565
Mailing address
4354 NW 23RD AVE # AVW, GAINESVILLE, FL 32606-6541
(352) 376-4565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP 9399487
FL
Other
Enumeration date
06/05/2014
Last updated
05/15/2022
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