Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARYSA P WALLACE, AGNP-C
ActiveMARYSA P WALLACE, AGNP-C is a Nurse Practitioner healthcare provider located in FAYETTEVILLE, Georgia. NPI 1932989357 is currently active in the NPPES registry. Verify at CMS.
Nurse Practitioner · FAYETTEVILLE, GA
Registration Details
- NPI Number
- 1932989357
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 3, 2023 (2.8230523022353 yrs)
- Last Updated
- Aug 14, 2024
- License
-
RN259981 (GA)
Practice Information
- Address
-
132 OLD NORTON RD STE 200FAYETTEVILLE, GA, 302154873Browse GA providers · Browse ZIP 30215
- Phone
- 6788171117
- Fax
- 6788170823
- Primary Specialty
-
Nurse Practitioner
363L00000X
Other Nurse Practitioner Providers in FAYETTEVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| BARBARA J CONLON | NP | 1558352823 |
| MRS. JAN MARIE SEILER | FNP | 1336252337 |
| KELLY ANNE KALLIS | CFNP | 1831244417 |
| DIANA RANNA | NP | 1871649889 |
| MS. DEBORAH BENTLEY | NP | 1548303399 |
| MRS. ROSINA IBETH ELLINGTON | ARNP | 1184873549 |
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.