PRINCESS GEHYIGON-WALLACE (NPI# 1275190027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275190027 |
| Entity Type | Individual |
| Full Name | PRINCESS GEHYIGON-WALLACE |
| Other Name | PRINCESS GEHYIGON |
| Practice Address |
1900 Silver Lake Rd Nw New Brighton MN 55112-1786 |
| Mailing Address |
1900 Silver Lake Rd Nw Ste 110 New Brighton MN 55112-1789 |
| Practice Telephone | 6516289566 |
| Mailing Telephone | 6516289566 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
6598 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 920 E 28th St Ste Ll40, Minneapolis, MN 554071192 | 6128712312 |
| Street Address |
1900 SILVER LAKE RD NW |
| City | NEW BRIGHTON |
| State | MN |
| Zip Code | 55112-1786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861492134 | Edwin Walker | Psychiatry & Neurology | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2005-07-28 |
| 1144833484 | Anna Marie Ricci | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-08-26 |
| 1568086346 | Kenneth Leroy King Sr. | Student in an Organized Health Care Education/Training Program | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-06-08 |
| 1184247108 | Alissa Marie Lambrides | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-05-26 |
| 1184247660 | Tammie Leetta Fullman | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-05-19 |
| 1396379541 | Meredith Lawlor | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-02-26 |
| 1154961225 | Ryan Jones | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2020-01-07 |
| 1902440944 | Olufemi Michael Adetunji | Nurse Practitioner | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-11-02 |
| 1174166672 | Williametta Augusta Wells | Counselor | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-10-28 |
| 1780227736 | Jason T Caspillo | Psychologist | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729704 | Owegio Wreh | Technician | 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 | 2020-04-22 |
| 1205497435 | Silver Lake Smiles Family Dentistry | Clinic/Center | 2370 Palmer Drive, New Brighton, MN 55112 | 2019-06-27 |
| 1932766169 | Matthew Thomas Hanowski | Dentist | 2442 Mounds View Boulevard, Mounds View, MN 55112 | 2019-05-22 |
| 1437619988 | Marjean Diane Leary | Registered Nurse | 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 | 2019-03-21 |
| 1558802728 | Krishna Katira | Student in an Organized Health Care Education/Training Program | 2442 County Hwy 10, Mounds View, MN 55112 | 2017-03-20 |
| 1245781608 | Evan Fredrick Lieberman | Counselor | 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 | 2016-10-20 |
| 1093262065 | Ryan Zinken | Nurse Practitioner | 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 | 2016-09-07 |
| 1447703228 | Alison Glodek | Social Worker | 2543 17th St Nw, New Brighton, MN 55112 | 2016-07-28 |
| 1659728194 | Ge Vang Sr. | Driver | 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 | 2016-05-14 |
| 1114373578 | Jessica Gapinski | Specialist/Technologist | 3900 Bethel Drive, Arden Hills, MN 55112 | 2016-05-04 |
| Find all providers in zip 55112 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488964 | Heather Mantsch | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 100, New Brighton, MN 55112-1786 | 2020-08-18 |
| 1093262065 | Ryan Zinken | Nurse Practitioner | 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 | 2016-09-07 |
| 1669019378 | Samson G Kpahn | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 | 2019-12-02 |
| 1902440944 | Olufemi Michael Adetunji | Nurse Practitioner | 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 | 2019-11-02 |
| 1801313283 | Elizabeth Kay Abraham | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 | 2017-08-25 |
| 1730621814 | Charles Sadder | Nurse Practitioner | 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 | 2016-11-07 |
| 1487100384 | Egle Otto | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 110, Nystrom & Associates, New Brighton, MN 55112-1789 | 2016-08-30 |
| 1689008062 | Leola Johnson | Nurse Practitioner | 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 | 2013-08-21 |
| 1770883993 | Heather Rochelle Teske | Nurse Practitioner | 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 | 2010-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234435 | Hawa Warsame Ali | Nurse Practitioner | 2650 Portland Ave, Minneapolis, MN 55407-1011 | 2020-10-27 |
| 1962009548 | Emily Ongaga | Nurse Practitioner | 43 10 Parkview Circle, Anoka, MN 55303 | 2020-10-06 |
| 1811504038 | Rita Jane Giglio | Nurse Practitioner | 201 Stade Ln, Fairmont, MN 56031-3227 | 2020-09-30 |
| 1568077725 | Linda Mongare | Nurse Practitioner | 3659 Tower Pond Dr, Anoka, MN 55303-8302 | 2020-09-14 |
| 1366056806 | Associates In Mental Health and Addiction Services. P.l.l.c | Nurse Practitioner | 166 W 3rd St Ste 202, Winona, MN 55987-6591 | 2020-09-02 |
| 1891308813 | Chelsey Paulson | Nurse Practitioner | 228 Krays Mill Rd, Cold Spring, MN 56320-4563 | 2020-08-28 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1326659210 | Monsurat Oluwa-okougbo | Nurse Practitioner | 1565 11th Ave, Newport, MN 55055-1650 | 2020-08-13 |
| 1629687124 | Justin Robert Wirth | Nurse Practitioner | 4801 Veterans Dr # 111, Saint Cloud, MN 56303-2015 | 2020-07-30 |
| 1336761261 | Mission Mental Health LLC | Nurse Practitioner | 1973 Sloan Pl Ste 50b, Maplewood, MN 55117-2084 | 2020-05-14 |
| Find all providers with the same taxonomy | ||||
| City | NEW BRIGHTON |
| Zip Code | 55112 |
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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.