MR. Phillip Tyler Wallace, APRN is an acute care nurse practitioner in Jacksonville, FL with 5 years of experience. MR. Phillip Tyler Wallace, APRN NPI is 1821647447. The provider is registered as an individual entity type and is a multi-specialty group.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL
ZIP 32207-567
Phone: (904) 253-6910
The NPI 1821647447 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 9/6/2019 and was last updated on 9/6/2019.