Individual
MS. KATIE LYNN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
67 S BEDFORD ST STE 101E, BURLINGTON, MA 01803-5152
(781) 744-8085
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0002
(781) 744-8085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2275454
MA
Other
Enumeration date
09/19/2014
Last updated
02/24/2023
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