Individual
TERRI ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
925 BEAR CORBITT RD, BEAR, DE 19701-1323
(302) 454-2400
Mailing address
200 TYRE AVE, NEWARK, DE 19711-7136
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
L10021724
DE
Other
Enumeration date
02/16/2007
Last updated
12/03/2018
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