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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. LISA CAROL WALLACE, FNP-BC

Active

MRS. LISA CAROL WALLACE, FNP-BC is a Family Nurse Practitioner healthcare provider located in ALLERTON, Iowa. NPI 1003423658 is currently active in the NPPES registry. Verify at CMS.

Family Nurse Practitioner · ALLERTON, IA

Registration Details

NPI Number
1003423658
Provider Type
Individual
Gender
Female
NPI Issued
Sep 28, 2020 (5.83483144431 yrs)
Last Updated
Sep 28, 2020
License
A160503 (IA)

Practice Information

Address
2418 180TH ST
ALLERTON, IA, 500088715
Browse IA providers · Browse ZIP 50008
Phone
6412030726
Primary Specialty
Family Nurse Practitioner
363LF0000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.