Cherry Wallace
NPI #1013886456 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1013886456
- Entity Type
- Individual
- Name
- Cherry Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Gerontology
- Enumeration Date
- Nov 3, 2025
- Last Updated
- Nov 4, 2025
Practice Location
- Address
- 425 N NEW BALLAS RD STE 203
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63141-6848
- Phone
- (314) 872-3104
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Gerontology — Gerontology |
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