| Doctor Name: | SHEILA REECE WALLS |
| NPI Number: | 1003082363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN054676 |
| Business Practice Address: | 100 Professional Pl Suite 104 Carrollton, GA - 301173874 |
| Business Phone Number: | 7708307039 |
| Business Fax Number: | 7708307149 |
| Mailing Address: | 100 Professional Pl, Suite 104 CARROLLTON |
| State: | GA |
| Postal Code: | 301173874 |
| Phone Number: | 7708307039 |
| Fax Number: | 7708307149 |
| NPI Enumeration Date: | 05/06/2008 |
| NPI Last Update Date: | 05/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN054676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |