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Susan Wallace
NPI 1104000199 · on the registry since 2007 · sole proprietor
Practice
- Address
- 17501 Dale Mabry Hwy N
Lutz, FL 33548 - Phone
- (813) 962-1000
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Adult Health Nurse Practitioner
363LA2200X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2007-12-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida