Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMY JO WALLACE, MD
ActivePediatrics · KERNERSVILLE, NC
Registration Details
- NPI Number
- 1467487322
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 11, 2006 (19.840551743026 yrs)
- Last Updated
- Nov 4, 2020
- Licenses
-
26169 (SC)200600865 (NC)
Practice Information
- Address
-
861 OLD WINSTON RD STE 101KERNERSVILLE, NC, 272847141Browse NC providers · Browse ZIP 27284
- Phone
- 3369040143
- Fax
- 3369040046
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in KERNERSVILLE, NC
| Name | Credential | NPI |
|---|---|---|
| REBECCA P BALL | MD | 1205836541 |
| MICHAEL E. ALBRIGHT | MD | 1982682183 |
| CATHY MARIE SOLDATO-COUTURE | MD | 1548229107 |
| GEORGE KIRK WALKER | MD | 1306808084 |
| LESLIE RIERSON SMITH | MD | 1356388540 |
| VANESSA KRISTEN AJIZIAN | MD | 1629002910 |
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.