Most Relevant Information
Provider Data
| NPI Number: | 1003368259 |
| Provider Name: | JAMES RYAN WALLACE CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | ARNP9386073 |
Most Important Dates
| Enumeration Date: | 11/03/2016 |
| Last Updated: | 01/15/2023 |
Provider Practice Location
1901 CLINCH AVE
KNOXVILLE
TN
379162307
Practice Location Phone/Fax
| Phone: | 8653429098 |
| Fax: |
Provider Mailing Location
PO BOX 10963
KNOXVILLE
TN
379390963
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |