Marlyn M. Wallace
Nurse Practitioner · Conyers, GA
UnclaimedNPI 1144790973
- Primary taxonomy
- 363L00000X
- Enumerated
- 2018-12-05
- Practice location
- Conyers, GA
- Last NPPES update
- 2018-12-05
State licenses
- GA · Nurse practitioner · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.