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LA' TAYSIA WALLACE, MSN, RN, CPNP-PC

MSN, RN, CPNP-PC

Pediatric Nurse Practitioner

NPI: 1114297074Individual

Specialties, Licenses & Credentials

Registered Nurse

Code: 163W00000X

716807-1(NY)

Licensed Practical Nurse

Code: 164W00000X

308886-1(NY)

Nurse Practitioner — Pediatrics

Code: 363LP0200X

F383676-01(NY)

Contact & Hours

Address
21 PENNY DR
HUNTINGTON STATION, NY 11746

Quick Facts

NPI
1114297074
Entity Type
Individual
Gender
Female
Medicare
Not confirmed
Specialties
3
Locations
1

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