Individual
MS. REBECCA H. WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN06
Contact information
Practice address
300 W MCMURRAY BLVD, CASA GRANDE, AZ 85222-3327
(520) 836-7310
(520) 836-2399
Mailing address
1485 N AMARILLO ST, CASA GRANDE, AZ 85222-2904
(520) 836-7310
(520) 836-2399
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN026547
AZ
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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