Wallace, Lisa

Wallace, Lisa is an individual health care provider with primary practice located at 200 Patewood Dr Ste B300 , Greenville SC 29615-6338. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Wallace, Lisa can be contacted via phone (864) 454-4200.

Contact Information

Primary practice address
200 Patewood Dr Ste B300 Greenville SC 29615-6338
Phone: (864) 454-4200
Fax: (864) 454-4205
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X NP-14866 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 28748 South Carolina

Profile Details

NPI number 1013349000
LBN Legal business name Wallace, Lisa
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2013
Last updated Sep 13th, 2024 - about 2 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.

Request for update

Popular Providers