JACQUE WALLIS (NPI# 1114546413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114546413 |
| Entity Type | Individual |
| Full Name | JACQUE WALLIS |
| Credential | RN |
| Practice Address |
1217 Riverside Ave Fort Collins CO 80524-3218 |
| Mailing Address |
4856 Innovation Dr Ste B Fort Collins CO 80525-5540 |
| Practice Telephone | 9704944200 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 88881 | CO | Nursing Service Providers |
| Street Address |
1217 RIVERSIDE AVE |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80524-3218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285628396 | Richard A Hohm | Surgery | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2005-09-02 |
| 1396356127 | Ana Cloeter | Case Manager/Care Coordinator | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-08-14 |
| 1083223937 | Aaron L Lesser | Case Manager/Care Coordinator | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-07-27 |
| 1619585205 | Alissa Stokes | Case Manager/Care Coordinator | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-07-20 |
| 1841808441 | Ruth Carrothers | Case Manager/Care Coordinator | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-07-20 |
| 1235754417 | Beth Mcclenathan | Registered Nurse | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-06-12 |
| 1992329684 | Alyssa King | Registered Nurse | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-05-29 |
| 1609497809 | Summitstone Health Partners | Clinic/Center | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-04-29 |
| 1316575350 | Kyle Turner | Case Manager/Care Coordinator | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-03-27 |
| 1285267153 | Lindsey Sutfin | Registered Nurse | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084612 | Summitstone Health Partners | Clinic/Center | 1008 Patton St., Fort Collins, CO 80524 | 2020-08-20 |
| 1396355244 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 1006 Robertson St., Ste. 120, Fort Collins, CO 80524 | 2020-08-05 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1013496835 | Stepheny Nicol Chapple | Psychologist | 701 S College Drive, 201, Fort Collins, CO 80524 | 2018-08-13 |
| 1609372432 | Tracy Jo Close | Counselor | 1031 Robinson Street, Fort Collins, CO 80524 | 2018-04-02 |
| 1831617828 | Rachel Elizabeth Brenner | Counselor | 151 W Lake Rd, Csu Health Network Counseling Services, Fort Collins, CO 80524 | 2017-08-30 |
| 1205366820 | Victoria Marie Sechser | Specialist/Technologist | 1102 Peterson St, Fort Collins, MN 80524 | 2017-06-15 |
| 1013367705 | Smith Street LLC | Day Training, Developmentally Disabled Services | 308 Smith St., Fort Collins, CO 80524 | 2016-06-14 |
| 1811344989 | Ignite Speech-language Services | Clinic/Center | 3921 Celtic Lane, Fort Collins, CO 80524 | 2016-05-18 |
| Find all providers in zip 80524 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549617 | Julie M Edwards | Registered Nurse | 3450 Lost Lake Pl Unit G1, Fort Collins, CO 80528-7055 | 2020-02-11 |
| 1861045049 | Shauna Raenell Escalante | Registered Nurse | 825 S Shields St Ste 6and7, Fort Collins, CO 80521-3590 | 2019-07-17 |
| 1568987998 | Megan Lagueux | Registered Nurse | 825 S Shields St Ste 6&7, Fort Collins, CO 80521-3590 | 2017-08-07 |
| 1578002242 | Jessica Doyle | Registered Nurse | 633 Agate Ct, Fort Collins, CO 80525-8226 | 2017-02-15 |
| 1013456789 | Michelle Keranen | Registered Nurse | 600 Hughes Way, Fort Collins, CO 80523-0001 | 2017-02-15 |
| 1205379898 | Michael Fine | Registered Nurse | 2302 Bowside Dr, Fort Collins, CO 80524-6812 | 2016-11-30 |
| 1326596669 | Leah Franklin | Registered Nurse | 4540 Seaway Cir, Fort Collins, CO 80525-3388 | 2016-09-15 |
| 1740640143 | Stephen Craig Anderson | Registered Nurse | 626 Prichett Ct, Fort Collins, CO 80525-8229 | 2016-02-26 |
| 1730547464 | John Rummel | Registered Nurse | 2419 Hollingbourne Dr, Fort Collins, CO 80526-1254 | 2016-02-09 |
| 1215313481 | Curt E Van Tress | Registered Nurse | 1136 E Stuart St Bldg 4 Ste 101, Fort Collins, CO 80525-1195 | 2015-08-10 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80524 |
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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.