Wallis, Elizabeth Nicole

Wallis, Elizabeth Nicole is an individual health care provider with primary practice located at 1937 S Burnside Ave , Gonzales LA 70737-4632. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wallis, Elizabeth Nicole can be contacted via phone (225) 765-5500.

Contact Information

Primary practice address
1937 S Burnside Ave Gonzales LA 70737-4632
Phone: (225) 765-5500
Fax: (225) 644-9286
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Louisiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 331615 Louisiana

Profile Details

NPI number 1821551334
LBN Legal business name Wallis, Elizabeth Nicole
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2019
Last updated Apr 11th, 2023 - about 3 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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