Most Relevant Information
Provider Data
| NPI Number: | 1003296484 |
| Provider Name: | JOHN HUGH WALLACE FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 246400 |
Most Important Dates
| Enumeration Date: | 06/01/2015 |
| Last Updated: | 05/28/2021 |
Provider Practice Location
319 SPRINGWOOD DR NE
VALDESE
NC
286908710
Practice Location Phone/Fax
| Phone: | 8288798419 |
| Fax: |
Provider Mailing Location
319 SPRINGWOOD DR NE
VALDESE
NC
286908710
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |