Individual ProviderDeborah Elaine WallaceNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3601 Tvc, Nashville, TN 37232-0001(615) 322-3000PECOS EnrollmentBased on the most recent information from CMS, provider Deborah Elaine Wallace does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:59 PM.Profile DetailsProvider ID1083859730Provider TypeIndividualFull NameWallace, Deborah ElaineTitleMrs.CredentialF.N.P.GenderFemaleSole ProprietorNoEnumeration Date12/10/2008Last Updated7/10/2012Contact InformationPractice LocationPractice Address3601 Tvc, Nashville, TN 37232-0001Phone(615) 322-3000FaxUnlisted FaxMailing LocationMailing Address3601 Tvc, Nashville, TN 37232-0001Phone(615) 322-3000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPN0000014879TennesseeCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN143968 NPGeorgia