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Marlyn Wallace
NPI 1144790973 · on the registry since 2018
Practice
- Address
- 3073 Klondike Rd Sw
Conyers, GA 30094 - Phone
- (678) 558-3106
Registry record
- Primary taxonomy
- Nurse Practitioner
363L00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-12-05
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 Georgia