Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. PHYLLIS A WALLACE, APRN
ActiveMRS. PHYLLIS A WALLACE, APRN is a Family Nurse Practitioner healthcare provider located in KONAWA, Oklahoma. NPI 1366486417 is currently active in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · KONAWA, OK
Registration Details
- NPI Number
- 1366486417
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 16, 2006 (20.16450531939 yrs)
- Last Updated
- Nov 22, 2021
- Licenses
-
R0035497 (OK)35497 (OK)
Practice Information
- Address
-
527 W 3RD STKONAWA, OK, 748491415Browse OK providers · Browse ZIP 74849
- Phone
- 5809253286
- Fax
- 5809259149
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
- Additional Specialty
- Family Nurse Practitioner
Other Family Nurse Practitioner Providers in KONAWA, OK
| Name | Credential | NPI |
|---|---|---|
| EMILY NICOLE DAVIS | APRN-CNP | 1649986431 |
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.