Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marlyn M. Wallace

Individual provider Nurse Practitioner · NPI 1144790973

Marlyn M. Wallace is a Nurse Practitioner in Conyers, Georgia. Qualified in 2017, 9 years ago. Practices with Atlanta Plus Primary Care LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2018

Practice location Address checks out

3073 Klondike Rd SW
Conyers, GA 30094-5660
Phone: (678) 558-3106
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN182038 (GA)

Record details

NPI number1144790973
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 5, 2018
Last updated in NPPESDecember 5, 2018
Mailing address3073 Klondike Rd Sw, Conyers, GA 30094-5660

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Atlanta Plus Primary Care Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Conyers