Individual
MRS. KAYLA JUNE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C, ARNP
Contact information
Practice address
1200 N 7TH ST, CHARITON, IA 50049-1210
(641) 774-8103
Mailing address
1200 N 7TH ST, CHARITON, IA 50049-1210
(641) 774-8103
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A119504
IA
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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