Female

Ms. Susan H. Wallace APRN

Nurse Practitioner in Omaha, NE(View on Map)

Full Name

Ms. Susan H Wallace APRN

NPI Number

1093826497

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/31/2006

Specialties

(Taxonomies)

Code

363L00000X

Primary Taxonomy

Yes

Licenses

State

Iowa
Nebraska

License Number

092180
110115

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 3755
16120 W DODGE RD

City

Omaha
Omaha

State

NE
NE

Postal Code

68103-0755
68118-2049

Country

US
US

Telephone Number

(402) 354-2100
(402) 354-0550

Identifiers

Identifier

1093826497
47068731727

Identifier State

IA
NE

Identifier Issuer

Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/20/2013

Provider Address

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