Wallace, Cleopatra

Wallace, Cleopatra is an individual health care provider with primary practice located at 777 Hemlock St , Macon GA 31201-2102. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Wallace, Cleopatra can be contacted via phone (478) 633-2147.

Contact Information

Primary practice address
777 Hemlock St Macon GA 31201-2102
Phone: (478) 633-2147
Fax: (478) 742-9670
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN181636 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN181636 Georgia

Profile Details

NPI number 1679959852
LBN Legal business name Wallace, Cleopatra
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2015
Last updated Mar 12th, 2018 - about 8 years ago

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.

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