Kelly Wallace, NP

NPI 1417609694 · on the registry since 2022 · sole proprietor

Practice

Address: 200 Medical Park Blvd
Petersburg, VA 23805
Phone: (804) 765-5000
Organisation at this address: Ahp Holdco Llc
Med-Trans Corporation
J. Houseworth, Dpm Llc
Clinical Colleagues Inc
Virginia Emergency Group Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 79

Registry record

Primary taxonomy: 363L00000X
363L00000X
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2022-01-27

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 Virginia