Wallace, Carrie B

Wallace, Carrie B is an sole proprietor health care provider with primary practice located at 414 Greenbelt Dr , Maryville TN 37804-5702. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wallace, Carrie B can be contacted via phone (865) 637-8812.

Contact Information

Primary practice address
414 Greenbelt Dr Maryville TN 37804-5702
Phone: (865) 637-8812
Fax: (865) 342-4678
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 16556 Tennessee

Profile Details

NPI number 1659646768
LBN Legal business name Wallace, Carrie B
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2012
Last updated Jun 18th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1659646768 NPPES
Tennessee MEDICAID Q005787

Popular Providers