Individual
KATIE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
917 CEDAR COVE RD, WELLINGTON, FL 33414-6305
(561) 635-0903
Mailing address
917 CEDAR COVE RD, WELLINGTON, FL 33414-6305
(561) 635-0903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9565667
FL
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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