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Nicole Wallace
NPI 1659224194 · on the registry since 2026
Practice
- Address
- 1865 Brickton Sta
Buford, GA 30518 - Phone
- (770) 625-0893
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-02-16
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