ANGELA D. WALLACE (NPI# 1295849081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295849081 |
| Entity Type | Individual |
| Full Name | ANGELA D. WALLACE |
| Credential | BS |
| Practice Address |
140 Hospital Dr South Williamson KY 41503-4022 |
| Mailing Address |
104 S Front Ave Prestonsburg KY 41653-1614 |
| Practice Telephone | 6062379873 |
| Practice Fax Number | 6062379723 |
| Mailing Telephone | 6068868572 |
| Mailing Fax Number | 6068864433 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073584652 | Angela M Wallace | Nurse Practitioner | 9300 Dewitt Loop Dept Of, Ft Belvoir, VA 22060-5285 | 2006-01-31 |
| 1417435819 | Angela Wallace | Counselor | 11222 Tesson Ferry Rd Ste 100, Saint Louis, MO 63123-6963 | 2018-07-30 |
| 1417452731 | Angela Kathleen Wallace | Marriage & Family Therapist | 554 S San Vicente Blvd Ste 200, Los Angeles, CA 90048-4651 | 2018-03-28 |
| 1750884631 | Angela M Wallace | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2018-03-16 |
| 1114204450 | Angela D Wallace | Counselor | 101 N Union Ave, Shawnee, OK 74801-7067 | 2011-11-15 |
| 1255510848 | Angela Darlene Wallace | Anesthesiology | 36000 Darnall Loop, Fort Hood, TX 76544-5095 | 2007-10-31 |
| Street Address |
140 HOSPITAL DR |
| City | SOUTH WILLIAMSON |
| State | KY |
| Zip Code | 41503-4022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851588370 | Curtis Edward Dotson | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2007-09-28 |
| 1184816902 | Hazel Lell | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2007-08-15 |
| 1447442272 | Jennifer Leigh Lyon | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2007-08-15 |
| 1659589216 | Phillip Thacker | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2007-05-18 |
| 1922130723 | Leigh Madison | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2007-03-09 |
| 1174631477 | Angela Newsome | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-27 |
| 1417061292 | Michael Maynard | Day Training/Habilitation Specialist | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-18 |
| 1053425843 | Franklin D. Varney | Day Training/Habilitation Specialist | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-18 |
| 1710090378 | Bryna Gene Jewell | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-17 |
| 1659484293 | Nickandrea M. Cooke | Counselor | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053782482 | Tackett-holschuh Radiology, Inc | Radiology | 411 Central Avenue, Suite 1, South Williamson, KY 41503 | 2015-10-12 |
| 1265843940 | Sherena Prince | Counselor | 70 New Camp Road, Lot 5, South Williamson, KY 41503 | 2014-05-15 |
| 1891745386 | Vellaiappan Somasundaram | Internal Medicine | 306 Hospital Drive, Suite 202c, South Williamson, KY 41503 | 2006-05-12 |
| 1437337144 | Dr. Gary T Smith Family Eye Care Inc | Durable Medical Equipment & Medical Supplies | 79 Mall Road, Southside Professional Bldg, Suite A, South Williamson, KY 41503 | 2008-02-05 |
| 1710192950 | Appalachian Regional Healthcare, Inc. | Nurse Practitioner | 306 Hospital Drive, South Williamson, KY 41503 | 2007-05-11 |
| 1861593048 | Betty Joan Karnes | Nurse Practitioner | 411 Central Ave, Suite 3, South Williamson, KY 41503 | 2006-09-26 |
| 1487762399 | Appalachian Regional Healthcare, Inc. | Clinic/Center | 306 Hospital Drive, South Williamson, KY 41503 | 2006-08-29 |
| 1740233402 | Teresa Renea Robinson | Nurse Practitioner | 306 Hospital Drive, Ste 202c, South Williamson, KY 41503 | 2006-05-17 |
| 1942275607 | Physical Therapy Clinic Psc | Clinic/Center | 275 Mall Road, Suite 1a, South Williamson, KY 41503-1632 | 2006-02-17 |
| 1821482555 | Bryan Fields | Pharmacist | 28093 Thompson Plaza, Food City Pharmacy, South Williamson, KY 41503-2719 | 2015-03-19 |
| Find all providers in zip 41503 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417061292 | Michael Maynard | Day Training/Habilitation Specialist | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-18 |
| 1053425843 | Franklin D. Varney | Day Training/Habilitation Specialist | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1740370022 | Kate Yocum Hensler | Day Training/Habilitation Specialist | 14107 Langland Pl, Louisville, KY 40245-4096 | 2006-10-15 |
| 1407947245 | Sydney Creason | Day Training/Habilitation Specialist | 111 E Kentucky Street, Louisville, KY 40203-2793 | 2006-09-27 |
| 1053424705 | Haley Marie Hammond | Day Training/Habilitation Specialist | 40 Greenhouse Ln, Rt 321 Auxier Rd, Prestonsburg, KY 41653-9180 | 2006-08-16 |
| 1073626727 | Eileen Schepers | Day Training/Habilitation Specialist | 40 Greenhouse Rd, Rt 321 Auxier Rd, Prestonsburg, KY 41653 | 2006-08-16 |
| 1205847233 | Barry D. Hall | Day Training/Habilitation Specialist | 160 Douglas Pk, Pikeville, KY 41501 | 2006-08-11 |
| 1669483699 | Willa Mae Hall | Day Training/Habilitation Specialist | 160 Douglas Park, Pikeville, KY 41501 | 2006-08-11 |
| 1477197291 | Allison Grace Worthy | Day Training/Habilitation Specialist | 1203 American Greeting Card Rd, Corbin, KY 40701-4811 | 2019-11-05 |
| 1952861718 | Deborah Johnson | Day Training/Habilitation Specialist | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-03-20 |
| 1184199440 | Ileen M Craig | Day Training/Habilitation Specialist | 1203 American Greeting Card Rd, Corbin, KY 40701-4811 | 2018-10-12 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH WILLIAMSON |
| Zip Code | 41503 |
Please comment or provide details below to improve the information on ANGELA D. 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.