MELISSA ANN WALLACE


Address: 905 University Dr, State College, PA 16801-6626
Phone: 8142388418

MELISSA ANN WALLACE (NPI# 1023524501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023524501
Entity Type Individual
Full Name MELISSA ANN WALLACE
Other Name MELISSA ANN BOETEL
Credential CRNP
Practice Address 905 University Dr
State College
PA 16801-6626
Practice Telephone 8142388418
Practice Fax Number 8142342888
Mailing Telephone 8142388418
Mailing Fax Number 8142342888
Enumeration Date 2017-12-20
Last Update Date 2019-11-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
SP018172 PA Physician Assistants & Advanced Practice Nursing Providers

Other Providers MELISSA WALLACE

NPI Name Taxonomy Address Enumeration
1396271243 Melissa Wallace Physical Therapy Assistant 3685 Mcconnells Hwy W, Sharon, SC 29742-5710 2017-05-11
1841656311 Melissa Emily Wallace Social Worker 1014 S Florida Ave Fl 2, Lakeland, FL 33803-1130 2016-01-13
1285903955 Melissa Wallace Physical Therapist 582 Hwy 365 Ste 3, Mayflower, AR 72106 2011-12-23
1619267101 Melissa Wallace Massage Therapist 161 Cactus Ct, Louisville, KY 40229-3109 2011-04-18
1972068278 Melissa S Wallace Licensed Practical Nurse 151 W 7th Ave Ste 163, Eugene, OR 97401-2676 2019-01-31
1881189181 Melissa Sue Wallace Counselor 3575 Pershing Ave, San Diego, CA 92104-3413 2018-06-28
1538609110 Melissa Wallace Case Manager/Care Coordinator 1124 College Dr, Rock Springs, WY 82901-5863 2017-03-02
1538607767 Melissa Wallace Counselor 841 Riverside Dr, Suite B, Augusta, ME 04330-8302 2017-02-08
1366804064 Melissa Wallace Case Manager/Care Coordinator 111 S Treaty Rd, Miami, OK 74354-5327 2016-03-22
1972988640 Melissa Wallace Social Worker 579 Courtlandt Ave, Bronx, NY 10451-5013 2015-07-23

Office Location

Street Address 905 UNIVERSITY DR
City STATE COLLEGE
State PA
Zip Code 16801-6626

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033102785 Guillard Internal Medicine Inc. Internal Medicine 905 University Dr, Suite 1, State College, PA 16801-6626 2005-08-29
1245875426 Jennifer L Thomas Physician Assistant 905 University Dr, State College, PA 16801-6626 2019-11-12
1255975892 Lauren B Davidson Nurse Practitioner 905 University Dr, State College, PA 16801-6626 2019-11-06
1124533138 Caitlin J Fernandez Nurse Practitioner 905 University Dr, State College, PA 16801-6626 2017-12-13
1407385479 Allison M Guillard Nurse Practitioner 905 University Dr, State College, PA 16801-6626 2017-06-05
1942627799 Katie Elizabeth Shelley Armold Physician Assistant 905 University Dr, State College, PA 16801-6626 2014-03-18
1164867867 Erin Marie Gabany Nurse Practitioner 905 University Dr, Ste 2, State College, PA 16801-6626 2013-05-08
1427317932 Blake Alexander Stewart Surgery 905 University Dr, State College, PA 16801-6626 2012-05-04
1508123407 Stephen Harry Phillips II Urology 905 University Dr, State College, PA 16801-6626 2012-04-16
1760794341 Geisinger Clinic Internal Medicine 905 University Dr, State College, PA 16801-6626 2010-07-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851880975 Creative Reflections Counseling, LLC Counselor 315 S Allen St Ste 124b, State College, PA 16801 2018-05-03
1679097901 Michelle L Grove Home Health Aide 2100 E College Ave Ste B, State College, PA 16801 2017-07-28
1740702034 Matthew Ishler Counselor 315 S. Allen Street Ste 326, State College, PA 16801 2017-07-09
1699206300 Emily Lauer Specialist/Technologist 102a Multisport Indoor Facility, State College, PA 16801 2017-03-23
1740721075 Luk Devorski Student in an Organized Health Care Education/Training Program Rec Hall University Park, Penn State University, State College, PA 16801 2017-03-20
1013465764 Pennsylvania Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 201 West Beaver Avenue, State College, PA 16801 2016-09-12
1740685858 Mallory L. Miller Physician Assistant 100 Radnor Rd Ste 101, State College, PA 16801 2014-10-31
1386053981 Christopher Hippenmeyer Specialist/Technologist 102a East Area Locker Building, Pennsylvania State University, University Park, PA 16801 2014-08-07
1982022059 Christy Sharer Counselor 301 S Allen St Ste 106, State College, PA 16801 2014-04-04
1912250523 Eva M Letwin Counselor 2011 Cato Ave Ste 201, State College, PA 16801 2012-10-19
Find all providers in zip 16801

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124395215 Michelle Lynn Fanning-hursh Nurse Practitioner 200 W Beaver Ave Ste 100, State College, PA 16801-4820 2011-11-17
1659536654 Geraldine M Budd Nurse Practitioner 2440 Chatham Ct, State College, PA 16803-2401 2008-07-20
1245210541 Tracey Allen Banks Nurse Practitioner 211 Noll Lab, State College, PA 16802 2006-01-20
1740264092 Marykathryn Corcoran Nurse Practitioner 315 South Allen St., Suite 417-a, State College, PA 16801 2005-11-30
1891320941 Jill Nicole Sathish Nurse Practitioner 32 Colonnade Way, State College, PA 16803-2309 2020-03-10
1255975892 Lauren B Davidson Nurse Practitioner 905 University Dr, State College, PA 16801-6626 2019-11-06
1821631631 Amber Renee Morrow Nurse Practitioner 2520 Green Tech Dr Ste C, State College, PA 16803-2308 2019-10-24
1366948192 Janet R Cady Nurse Practitioner 1850 E Park Ave Ste 201, State College, PA 16803 2018-04-02
1124533138 Caitlin J Fernandez Nurse Practitioner 905 University Dr, State College, PA 16801-6626 2017-12-13
1457885188 Sarah A Guillard Nurse Practitioner 1800 E Park Ave, State College, PA 16803-6709 2017-04-19
Find all providers in STATE COLLEGE

Competitor

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City STATE COLLEGE
Zip Code 16801

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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