MRS. TALIA NICOLE WALLACE (NPI# 1063937753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063937753 |
Entity Type | Individual |
Full Name | MRS. TALIA NICOLE WALLACE |
Credential | FNP-C |
Practice Address |
10215 Fernwood Rd Ste 100 Bethesda MD 20817-1183 |
Practice Telephone | 3014934440 |
Practice Fax Number | 3014939778 |
Mailing Telephone | 3014934440 |
Mailing Fax Number | 3014939778 |
Enumeration Date | 2017-08-03 |
Last Update Date | 2019-07-03 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AC002032 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
8701 Georgia Ave Ste 100, Silver Spring, MD 209103736 | 3015627390 |
Street Address |
10215 FERNWOOD RD STE 100 |
City | BETHESDA |
State | MD |
Zip Code | 20817-1183 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558336321 | Brent K. Cole | Internal Medicine | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2006-02-23 |
1649815341 | Alexandra Leggett Kelly | Physician Assistant | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2019-11-18 |
1235604851 | John Luke Hudson | Physician Assistant | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2018-10-10 |
1144704982 | Emily D Burnworth | Physician Assistant | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2018-09-18 |
1770986861 | Anne Fetcher Milam | Physician Assistant | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2014-10-02 |
1487786604 | Daniela N Hangan | Family Medicine | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2007-03-12 |
1639241136 | Suvarnarekha Abhyankar Kammula | Internal Medicine | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2006-11-14 |
1790856433 | Andrea C Karp | Internal Medicine | 10215 Fernwood Rd Ste 100, Bethesda, MD 20817-1183 | 2006-11-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972135291 | Super Smile Center of Bethesda | Dentist | 10320 Westlake Dr., Suite# 109, Bethesda, MD 20817 | 2020-02-05 |
1659918175 | Morgan Cheatham | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd, Suite 300, Bethesda, MD 20817 | 2019-12-03 |
1780233601 | Natalie Milazzo | Behavior Technician | Attattn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-09-04 |
1366090649 | Sarah Danko | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-29 |
1679120760 | Markita Mccurdy | Behavior Technician | 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-22 |
1548716277 | Roberta Glass | Psychiatry & Neurology | 9806 Marquette Dr., Bethesda, MD 20817 | 2016-09-01 |
1952725525 | Jenna Kuhn | Student in an Organized Health Care Education/Training Program | 6701 Democracy Blvd. Attn: Behavioral Health Works, Suite 300, Bethesda, MD 20817 | 2014-02-18 |
1912338088 | Nayereh Nina Ghamarian | Dentist | 6017 Bradley Blvd, Bethesda, MD 20817 | 2013-11-27 |
1386076495 | Hugo Galindo | Physical Therapist | 6410 Rockledge Drive, Suite 100, Nrh Rehabilitation Network Bethesda, Bethesda, MD 20817 | 2013-07-31 |
1538509260 | Anameti Usoro | Anesthesiology | 6430 Rockledge Dr Ste 160, Bethesda, MD 20817 | 2013-06-26 |
Find all providers in zip 20817 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598365082 | Chibuzor Susan Igolo | Nurse Practitioner | 4494 N Palmer Rd N, Bethesda, MD 20814 | 2020-10-26 |
1407454671 | Yasamin Baghaipour | Nurse Practitioner | 10115 Parkwood Dr, Bethesda, MD 20814-4033 | 2020-10-11 |
1174132682 | Touko Leuga | Nurse Practitioner | 6410 Rockledge Dr Ste 110, Bethesda, MD 20817-1825 | 2020-07-30 |
1073170346 | Tonya Lynn Jenkins | Nurse Practitioner | 10 Center Drive 3ne, Bethesda, MD 20892-0001 | 2019-05-22 |
1366909848 | Crystal Flowers | Nurse Practitioner | Bg 10-crc Rm 1-3750, 10 Center Dr, Bethesda, MD 20814 | 2019-02-21 |
1043718653 | Mahsa Motevalli | Nurse Practitioner | 8600 Old Georgetown Rd Fl 6, Bethesda, MD 20814 | 2018-01-29 |
1558806778 | Keshia C Thompson | Nurse Practitioner | National Institutes of Health Building 10, Room 2c145, Bethesda, MD 20892-1662 | 2016-12-23 |
1083160402 | Britanny Brooke Solarz | Nurse Practitioner | 10 Center Drive Building 10 2b46, Bethesda, MD 20892-0001 | 2016-08-26 |
1710333281 | Deirdre Fionna Angelastro | Nurse Practitioner | 4938 Saint Elmo Ave, Bethesda, MD 20814-6008 | 2016-05-13 |
1902262447 | Relia Atienza | Nurse Practitioner | National Institute of Br, 10 Center Drive, Bethesda, MD 20892-0001 | 2016-01-13 |
Find all providers in BETHESDA |
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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.