Marysa Wallace, AGNP-C

NPI 1932989357 · on the registry since 2023

Practice

Address: 132 Old Norton Rd Ste 200
Fayetteville, GA 30215
Phone: (678) 817-1117
Fax: (678) 817-0823
Organisation at this address: Georgia Cancer Specialists I Pc
Nsh Cancer Institute Professional Services G Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

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: 2024-08-14

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