Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA ANN WALLACE
ActiveLISA ANN WALLACE is a Licensed Practical Nurse healthcare provider located in HORTON, Michigan. NPI 1992368872 is currently active in the NPPES registry. Verify at CMS.
Licensed Practical Nurse · HORTON, MI
Registration Details
- NPI Number
- 1992368872
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 17, 2019 (7.3272871729426 yrs)
- Last Updated
- Dec 12, 2023
- License
-
4703086959 (MI)
Practice Information
- Address
-
8700 MOSHERVILLE RDHORTON, MI, 492469601Browse MI providers · Browse ZIP 49246
- Phone
- 5173585830
- Primary Specialty
-
Licensed Practical Nurse
164W00000X
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.