IndividualActive
Kimberly Wallace, RN
NPI 1104534395 · General Practice Registered Nurse · Huntsville, AL
Provider details
- NPI number
- 1104534395
- Entity type
- Individual
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 1-069756 (AL)
Specialties & taxonomies
Nursing Service Providers
Practice location
204 Lowe Ave Se Ste 2
Huntsville, AL 35801-4242
Phone: (256) 534-7235
Approximate (ZIP-level) locationGet directions
Mailing address
3118 Mallard Point Dr Se
Owens Cross Roads, AL 35763-8497
Registry dates
- Enumerated
- 2022-11-07
- Last updated
- 2022-11-07
- Certified
- 2022-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.