Provider Demographics
NPI:1053136549
Name:WALLACE, FRANKIE D (DOULA)
Entity type:Individual
Prefix:
First Name:FRANKIE
Middle Name:D
Last Name:WALLACE
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-2308
Mailing Address - Country:US
Mailing Address - Phone:215-259-8372
Mailing Address - Fax:
Practice Address - Street 1:1374 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-2308
Practice Address - Country:US
Practice Address - Phone:215-259-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula