LAURA ANN WALLACE (NPI# 1265737753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265737753 |
| Entity Type | Individual |
| Full Name | LAURA ANN WALLACE |
| Credential | A.P.N |
| Practice Address |
1445 Us Highway 51 Byp E Dyersburg TN 38024-2127 |
| Practice Telephone | 7312861900 |
| Practice Fax Number | 7312861939 |
| Mailing Telephone | 7312861900 |
| Mailing Fax Number | 7312861939 |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2014-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000015481 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721701 | Laura Wallace | Behavioral Analyst | 925 Roxburgh Ave, Rock Hill, SC 29732-5505 | 2020-05-14 |
| 1841859576 | Laura A Wallace | Technician | 242 37th St Se Apt 11, Washington, DC 20019-3161 | 2019-06-06 |
| 1679047005 | Laura J Wallace | Advanced Practice Midwife | 115 Eagle Spring Dr Ste A200, Stockbridge, GA 30281-6486 | 2019-01-18 |
| 1699271080 | Laura L Wallace | Licensed Practical Nurse | 2518 Portage Grove Ct, Wooster, OH 44691-1975 | 2018-04-04 |
| 1003140062 | Laura L Wallace | Registered Nurse | 3425 Sw Kimstin Cir, Blue Springs, MO 64015-4579 | 2009-09-23 |
| 1659515013 | Laura Beth Wallace | Marriage & Family Therapist | 3430 Sw 320th St Ste D2, Federal Way, WA 98023-2292 | 2009-04-28 |
| 1417566910 | Laura Anne Wallace | Case Manager/Care Coordinator | 920 W Broadway St, Hobbs, NM 88240-5529 | 2020-07-30 |
| 1841619848 | Laura Jean Wallace | Pediatrics | 8600 Nicollet Ave S, Bloomington, MN 55420-2824 | 2014-04-08 |
| 1457698920 | Laura Ann Wallace | Physical Therapist | 2900 Hawkins Dr, Searcy, AR 72143-4802 | 2013-01-03 |
| 1407119779 | Laura Wallace | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2012-06-20 |
| Street Address |
1445 US HIGHWAY 51 BYP E |
| City | DYERSBURG |
| State | TN |
| Zip Code | 38024-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205832920 | Jan Allison Sims | Nurse Practitioner | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2005-06-27 |
| 1285156901 | Care Rite Pllc | Clinic/Center | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2017-07-14 |
| 1891035044 | James Dalton Tetleton | Nurse Practitioner | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2013-02-26 |
| 1477827418 | Care Rite Pllc | Family Medicine | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2012-03-07 |
| 1922390418 | Hari Krishna Salana | Family Medicine | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2011-05-03 |
| 1467594184 | Angeli Jain | Family Medicine | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2007-02-12 |
| 1437201860 | Sandra Jean Fowlkes | Nurse Practitioner | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2007-01-17 |
| 1487655957 | Pankaj Srivastava | Internal Medicine | 1445 Us Highway 51 Byp E, Suite C, Dyersburg, TN 38024-2127 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760273 | Alison Clement | Nurse Practitioner | 750 W Highway 51 Bypass, Dyersburg, TN 38024 | 2020-01-29 |
| 1861030652 | Pagela Jobe | Nurse Practitioner | 750 West Highway 51 Bypass, Dyersburg, TN 38024 | 2019-12-12 |
| 1083184055 | Whitney Young | Nurse Practitioner | 455 East Parkview, Dyersburg, TN 38024 | 2018-12-03 |
| 1518434067 | Myeyedr Optometry of Tennessee, LLC | Optometrist | 400 Us Hwy 51 S, Dyersburg, TN 38024 | 2018-11-01 |
| 1225529142 | Kidney Experts Pllc | Internal Medicine | 1575 Parr Ave # B, Dyersburg, TN 38024 | 2018-05-25 |
| 1407344690 | Darnisha Williams | Pharmacist | 2650 Lake Road, Dyersburg, TN 38024 | 2018-04-24 |
| 1376081547 | Chasidy Branch | Counselor | 640 U.S. Highway 51 Bypass E. Suite M, Dyersburg, TN 38024 | 2017-02-07 |
| 1548671845 | Shree Ramakant Mulay | Internal Medicine | 1575 Parr Ave Ste B, Dyersburg, TN 38024 | 2014-05-08 |
| 1588904965 | Selina Carol Purvis | Physical Therapy Assistant | 1900 Parr Avenue, Dyersburg, TN 38024 | 2013-02-22 |
| 1326396029 | Tennessee Sleep Managment LLC | Clinic/Center | 1190 Hwy 51 By-pass West, Suite C, Dyersburg, TN 38024 | 2012-08-28 |
| Find all providers in zip 38024 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760273 | Alison Clement | Nurse Practitioner | 750 W Highway 51 Bypass, Dyersburg, TN 38024 | 2020-01-29 |
| 1861030652 | Pagela Jobe | Nurse Practitioner | 750 West Highway 51 Bypass, Dyersburg, TN 38024 | 2019-12-12 |
| 1538690342 | Brittany Bennett | Nurse Practitioner | 1954 Saint John Ave, Suite 1, Dyersburg, TN 38024-2120 | 2017-03-23 |
| 1982008850 | Kalie Foust | Nurse Practitioner | 2550 Parr Ave, Dyersburg, TN 38024-2033 | 2014-10-21 |
| 1396160222 | Wanda Beaver | Nurse Practitioner | 708 E Court St, Dyersburg, TN 38024-4829 | 2014-03-01 |
| 1932449386 | Teresa Ann Stewart | Nurse Practitioner | 1700 Woodlawn Avenue, Dyersburg, TN 38024-1572 | 2013-02-21 |
| 1770763674 | Lucy Elaine Sturdivant | Nurse Practitioner | 2395 Lake Rd, Dyersburg, TN 38024-1831 | 2007-11-07 |
| 1306990262 | Vonda Leeann Emerson | Nurse Practitioner | 1950 Cook Street, Dyersburg, TN 38024 | 2007-01-22 |
| 1942249677 | Sheryl Lynn Wright | Nurse Practitioner | 2017 Saint John Ave, Suite B, Dyersburg, TN 38024-2209 | 2006-06-06 |
| 1891797924 | Syble S Carter | Nurse Practitioner | 520 Parkview E, Dyersburg, TN 38024 | 2005-08-10 |
| Find all providers in DYERSBURG | ||||
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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.