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

MS. Susan Ann Wallace

Individual provider Adult Health Nurse Practitioner · NPI 1104000199

MS. Susan Ann Wallace is an Adult Health Nurse Practitioner in Lutz, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2007
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Practice location Address checks out

17501 Dale Mabry Hwy N
Lutz, FL 33548-4521
Phone: (813) 962-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence ARNP3262052 (FL)

Record details

NPI number1104000199
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 26, 2007
Last updated in NPPESDecember 26, 2007
Mailing address17501 Dale Mabry Hwy N, Lutz, FL 33548-4521

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