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

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

Practice location Address checks out

17501 Dale Mabry Hwy N
Lutz, FL 33548-4521
Phone: (813) 962-1000
Show map & directions

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

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