DONNETTA L WALLACE

STELLIS HEALTH, PA

Dr DONNETTA L WALLACE is a female medical professional, specializing in Nurse Practitioner. She graduated in 2013.

Contact

STELLIS HEALTH, PA

11091 JASON NEAVE
ALBERTVILLE
MN
553014699

Tel: 7636848300

DONNETTA L WALLACE Information

Npi 1922436914
Pac Id 5799912895
Professional Enrollment Id I20131217001429
Last Name WALLACE
First Name DONNETTA
Middle Name L
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 2013
Primary Specialty NURSE PRACTITIONER
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name STELLIS HEALTH, PA
Group Practice Pac Id 1153233796
Number Of Group Practice Members 63
Line 1 Street Address 11091 JASON NEAVE
Line 2 Street Address
Marker Of Address Line 2 Suppression
City ALBERTVILLE
State MN
Zip Code 553014699
Phone Number 7636848300
Hospital Affiliation Ccn 1 240001
Hospital Affiliation Lbn 1 NORTH MEMORIAL MEDICAL CENTER
Hospital Affiliation Ccn 2 241362
Hospital Affiliation Lbn 2 CENTRACARE HEALTH - MONTICELLO
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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