MICHELLE DIANNE WALLACE (NPI# 1316471790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316471790 |
| Entity Type | Individual |
| Full Name | MICHELLE DIANNE WALLACE |
| Credential | FNP-C |
| Practice Address |
8970 S Meridian St Indianapolis IN 46217-5031 |
| Practice Telephone | 3173747779 |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
28184348A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770051252 | Michelle Wallace | Technician | 1515 Sumac Rd, Fort Gibson, OK 74434-7512 | 2018-11-02 |
| 1437524196 | Michelle Wallace | Physical Therapist | 473 Auxier Dr, Cincinnati, OH 45244-2364 | 2015-12-07 |
| 1497091805 | Michelle Lynn Wallace | Specialist | 508 Blair Blvd, Eugene, OR 97402-4630 | 2012-12-13 |
| 1477808947 | Michelle Wallace | Physical Medicine & Rehabilitation | 75 Norman Pl, Tenafly, NJ 07670-2537 | 2012-07-19 |
| 1598884272 | Michelle Marie Wallace I | Registered Nurse | 17887 State Route 58, Wellington, OH 44090-9464 | 2007-03-27 |
| 1336796374 | Michelle Wallace | Counselor | 369 Ne Revere Ave Ste 101, Bend, OR 97701-4082 | 2019-08-23 |
| 1972044519 | Michelle D Wallace | Durable Medical Equipment & Medical Supplies | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2017-03-15 |
| 1275938185 | Michelle Mayer Wallace | Pharmacist | 2413 Highway 431 North, Anniston, AL 36206 | 2014-11-04 |
| 1912249822 | Michelle M Wallace | Physical Therapist | 2300 Trenton Rd, Levittown, PA 19056-1423 | 2013-03-19 |
| 1609136266 | Michelle Wallace | Social Worker | 245 E 19th St, Apt. 12f, New York, NY 10003-2639 | 2012-05-16 |
| Street Address |
8970 S MERIDIAN ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46217-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063496701 | Dian Lynn Covert | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2005-12-06 |
| 1780299768 | Megan Tebbe | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2020-09-15 |
| 1932768546 | Michelle Miller | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2019-06-07 |
| 1861891624 | Karen A Mckinney | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2014-08-18 |
| 1144566076 | Katherine Ann Davis | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2012-12-20 |
| 1831460963 | Weiwei Wang | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2012-01-20 |
| 1912000613 | Hook Superx LLC | Pharmacy | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992318158 | Maria Yvette Borden | Student in an Organized Health Care Education/Training Program | University of Indianapolis, Health Pavilion 253, Indianapolis, IN 46217 | 2020-08-27 |
| 1457900375 | Kara Combs | Technician | 8737 Winding Ridge Rd, Indianapolis, IN 46217 | 2019-09-04 |
| 1750789459 | Stephanie Johnson | Specialist/Technologist | 8542 Gallant Fox Dr., Indianapolis, IN 46217 | 2014-12-11 |
| 1336480623 | Lauren Marie Carter | Nurse Practitioner | 8970 S Meridian St., Indianapolis, IN 46217 | 2013-03-12 |
| 1912175662 | Staci L Vanzant | Social Worker | 8820 N Meridian St, Ste 225, Indianapolis, IN 46217 | 2008-02-15 |
| 1568684934 | Lifetime Dental Care of Indiana, PC | Dentist | 8923 South Meridian Street, Suite B, Indianapolis, IN 46217 | 2007-05-03 |
| 1912093659 | Anna Marie Heidenreich | Pharmacist | 8820 S Meridian #105, Indianapolis, IN 46217 | 2006-10-04 |
| 1669955449 | Jason Soultz | Nurse Practitioner | 1330 W Southport Rd, Indianapolis, IN 46217 | 2018-09-08 |
| 1649400896 | Nakeeta Stansberry | Nurse Practitioner | 1330 W Southport Rd, Indianapolis, IN 46217 | 2009-07-22 |
| 1316083652 | Linnea J. Nelson | Family Medicine | 6925 S Harding St, Suite B-1, Indianapolis, IN 46217 | 2007-01-30 |
| Find all providers in zip 46217 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1922614965 | Children Express Care Clinic LLC | Nurse Practitioner | 5435 Emerson Way Ste 110, Indianapolis, IN 46226-1470 | 2020-09-16 |
| 1255956272 | Heather Nicole Zore | Nurse Practitioner | 9240 N Meridian St Ste 225, Indianapolis, IN 46260-1880 | 2020-06-15 |
| 1457976615 | Adam Weir | Nurse Practitioner | 960 E Washington St, Indianapolis, IN 46202-3981 | 2020-06-13 |
| 1457975740 | Ayee Teah Bleemie | Nurse Practitioner | 429 E Vermont St Ste 100, Indianapolis, IN 46202-3688 | 2020-06-02 |
| 1689294357 | May Josefa Ishikawa | Nurse Practitioner | 705 Riley Hospital Dr Ste 2240, Indianapolis, IN 46202-5109 | 2020-04-22 |
| 1760001200 | John Shaver | Nurse Practitioner | 3750 N Meridian St Ste 100, Indianapolis, IN 46208-4300 | 2020-04-14 |
| 1851931000 | Robin L Petit | Nurse Practitioner | 6925 S Harding St Ste B-1, Indianapolis, IN 46217-4114 | 2020-01-15 |
| 1952941577 | Andreya Beckett | Nurse Practitioner | 3500 Depauw Blvd Ste 1041, Indianapolis, IN 46268-6125 | 2020-01-11 |
| 1053950105 | Shannon Malecki | Nurse Practitioner | 550 University Blvd Ste 5630, Indianapolis, IN 46202-5149 | 2020-01-06 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46217 |
Please comment or provide details below to improve the information on MICHELLE DIANNE 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.