Elizabeth Ann Wallace, FNP-BC
Nurse Practitioner, Family in Knoxville, TN. Individual provider (NPI-1).
NPI number1982159356
StatusActive
Last updated in NPPESSep 6, 2024
Details
- NPI
- 1982159356
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Ann Wallace
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 16, 2016
- Certification date
- Sep 6, 2024
- Last updated
- Sep 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 21538 | TN | Yes |
| 363L00000X | Nurse Practitioner | 21538 | TN |
Other names
- Elizabeth A Blair (Former Name)
Practice location
2001 Laurel Ave Ste 105Knoxville, TN 37916-1867
Phone 865-577-9247 · Fax 833-908-2095
Mailing address
1275 Dick Lonas RdKnoxville, TN 37909-1382
Phone 865-584-4747 · Fax 865-381-1509
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