Individual
ELIZABETH ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2001 LAUREL AVE STE 105, KNOXVILLE, TN 37916-1867
(865) 577-9247
(833) 908-2095
Mailing address
1275 DICK LONAS RD, KNOXVILLE, TN 37909-1382
(865) 584-4747
(865) 381-1509
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21538
TN
363LF0000X
Family Nurse Practitioner
Primary
21538
TN
Other
Enumeration date
08/16/2016
Last updated
09/06/2024
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