MS. Kimberly Wallace, LRN

NPI #1114249117 in Kennett, Missouri

Provider Information

NPI Number: 1114249117
Entity Type: Individual
Name: MS. Kimberly Wallace, LRN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: LRN
Enumeration Date: Feb 18, 2010
Last Updated: Feb 18, 2010

Practice Location

Address: 925 HIGHWAY V V
City: Kennett
State: Missouri
ZIP Code: 63857
Phone: (573) 888-5925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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