Kimberly Lane Wallace, NP-C is a primary care nurse practitioner in Beavercreek, OH with 2 years of experience. Kimberly Lane Wallace, NP-C NPI is 1619688116. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
3535 PENTAGON BLVD
BEAVERCREEK, OH
ZIP 45431-705
Phone: (937) 702-4000
The NPI 1619688116 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 12/6/2022 and was last updated on 12/6/2022.