MAUREEN WALLACE (NPI# 1073559399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073559399 |
| Entity Type | Individual |
| Full Name | MAUREEN WALLACE |
| Credential | PA-C |
| Practice Address |
514 E Whitehouse Canyon Rd Ste 110 Green Valley AZ 85614-0539 |
| Mailing Address |
3945 E Paradise Falls Dr Ste 201 Tucson AZ 85712-6687 |
| Practice Telephone | 5206897030 |
| Practice Fax Number | 5203959796 |
| Mailing Telephone | 5206897030 |
| Mailing Fax Number | 5203959796 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3191 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 121 West Esperanza Blvd, 118, Green Valley, AZ 85614 | 5206897030 | 5203959796 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366599334 | Maureen Wallace | Social Worker | 919 Village Center, Ste 7, Lafayette, CA 94549-3599 | 2007-01-04 |
| 1396761995 | Maureen V Wallace | Physical Therapist | 2430 N. 7th, Unit 2, Bozeman, MT 59715 | 2006-07-15 |
| 1184854549 | Maureen Elizabeth Wallace | Psychologist | 423 W 55th St, 4th Floor, New York, NY 10019-4460 | 2009-07-20 |
| 1952424525 | Maureen Kay Wallace | Physician Assistant | 6624 Fannin St, Suite 2400, Houston, TX 77030-2312 | 2007-04-09 |
| 1932298452 | Maureen L Wallace | Audiologist | 215 Pesetas Ln, Santa Barbara, CA 93110-1416 | 2006-10-12 |
| 1790722015 | Maureen Patricia Wallace | Dietitian, Registered | 753 Virginia St, Dunedin, FL 34698-6615 | 2006-06-02 |
| Street Address |
514 E WHITEHOUSE CANYON RD STE 110 |
| City | GREEN VALLEY |
| State | AZ |
| Zip Code | 85614-0539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386264885 | Arizona Blood and Cancer Specialists, Pllc | Internal Medicine | 514 E Whitehouse Canyon Rd Ste 110, Green Valley, AZ 85614-0539 | 2020-04-24 |
| 1275807422 | Molly Grassman | Physician Assistant | 514 E Whitehouse Canyon Rd Ste 110, Green Valley, AZ 85614-0539 | 2012-03-06 |
| 1124171533 | Sivamurthy Kyathari | Internal Medicine | 514 E Whitehouse Canyon Rd Ste 110, Green Valley, AZ 85614-0539 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773791 | Medavail Pharmacy Inc. | Pharmacy | 5750 S Turquoise Canyon Dr, Green Valley, AZ 85614 | 2019-04-29 |
| 1447742788 | Shanae Murphy | Nurse Practitioner | 1260 S Campbell Ave Unit 2, Green Valley, AZ 85614 | 2018-06-02 |
| 1487173332 | Chirocade, Inc. | Chiropractor | 380 W Vista Hermosa Dr., Ste # 100, Green Valley, AZ 85614 | 2017-09-12 |
| 1922536150 | Melinda Suzanne Prado | Dental Hygienist | 1260 S Campbell Rd Bldg 2, Green Valley, AZ 85614 | 2017-06-01 |
| 1295274579 | Nitika Sharma | Dentist | Dental Village, 140 W Duval Mine Rd, Green Valley, AZ 85614 | 2017-02-19 |
| 1508212960 | Amy Priftakis | Nurse Practitioner | 4455 N I-19 Frontage Rd., Green Valley, AZ 85614 | 2016-05-04 |
| 1730547134 | Cope Community Services, Inc. | Psychiatry & Neurology | 1660 W Commerce Point Pl, Green Valley, AZ 85614 | 2016-02-01 |
| 1548656457 | Southern Arizona Sleep Solutions | Durable Medical Equipment & Medical Supplies | 261 W Duval Road, Green Valley, AZ 85614 | 2015-04-08 |
| 1770978041 | Empower Green Valley Pllc | Emergency Medicine | 4455 S. I-19 Frontage Road, Greenvalley, AZ 85614 | 2015-04-02 |
| 1295125078 | Gv Hospital Management LLC | General Acute Care Hospital | 4455 South I-19 Frontage Road, Green Valley, AZ 85614 | 2015-01-30 |
| Find all providers in zip 85614 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275807422 | Molly Grassman | Physician Assistant | 514 E Whitehouse Canyon Rd Ste 110, Green Valley, AZ 85614-0539 | 2012-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
| City | GREEN VALLEY |
| Zip Code | 85614 |
Please comment or provide details below to improve the information on MAUREEN WALLACE.
| 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.