MR. Michael Alan Wallace, CNP
NPI #1003057852 in Albuquerque, New Mexico
Provider Information
- NPI Number
- 1003057852
- Entity Type
- Individual
- Name
- MR. Michael Alan Wallace, CNP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- CNP
- Enumeration Date
- Mar 7, 2009
- Last Updated
- Mar 11, 2013
Practice Location
- Address
- 8210 LOUISIANA BLVD NE
- Address 2
- SUITE C
- City
- Albuquerque
- State
- New Mexico
- ZIP Code
- 87113-1761
- Phone
- (505) 858-1222
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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