ELIZABETH WALLIS (NPI# 1326681800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326681800 |
| Entity Type | Individual |
| Full Name | ELIZABETH WALLIS |
| Credential | PA-C |
| Practice Address |
7400 France Ave S Ste 100 Edina MN 55435-4738 |
| Mailing Address |
596 Ottawa Ave Saint Paul MN 55107-2528 |
| Practice Telephone | 7635376000 |
| Mailing Telephone | 6517077771 |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
13183 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821551334 | Elizabeth Nicole Wallis | Student in an Organized Health Care Education/Training Program | 7777 Hennessy Blvd Ste 6004, Baton Rouge, LA 70808-4300 | 2019-04-11 |
| 1740528546 | Elizabeth Leanne Wallis | Nurse Practitioner | 110 Medical Cir, Nashville, AR 71852-8606 | 2013-01-29 |
| 1023344025 | Elizabeth Mary Wallis | Pediatrics | 171 Ashley Ave, Charleston, SC 29425-8908 | 2009-10-26 |
| Street Address |
7400 FRANCE AVE S STE 100 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-4738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659345783 | Steven B Vandonselaar | Physician Assistant | 7400 France Ave S Ste 100, Edina, MN 55435-4738 | 2006-02-15 |
| 1164990842 | Rougui B Bah | Nurse Practitioner | 7400 France Ave S Ste 100, Edina, MN 55435-4738 | 2018-11-11 |
| 1306215744 | Christine Nangendo Nsubuga | Nurse Practitioner | 7400 France Ave S Ste 100, Edina, MN 55435-4738 | 2015-09-16 |
| 1588842744 | Richard Scott Stayner | Anesthesiology | 7400 France Ave S Ste 100, Edina, MN 55435-4738 | 2008-02-08 |
| 1851409098 | Peter J Schultz | Internal Medicine | 7400 France Ave S Ste 100, Edina, MN 55435-4738 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821423781 | Sarah L Davis | Physician Assistant | 6405 France Ave S Ste 200, Edina, MN 55435 | 2013-09-11 |
| 1811239049 | Britney Dael Foster Busse | Physician Assistant | 3916 W 50th St, Edina, MN 55424-1202 | 2013-03-26 |
| 1073573630 | Alan Richard Harrison Jr. | Physician Assistant | 7373 France Ave S., Suite 300, Edina, MN 55435-4538 | 2006-03-27 |
| 1821094392 | Lisa T Ley | Physician Assistant | 3400 W 66th St, Ste 385, Edina, MN 55435-2197 | 2005-06-21 |
| 1841759438 | Emma Cyr | Physician Assistant | 6565 France Ave S Ste 375, Edina, MN 55435-2141 | 2019-03-14 |
| 1023581337 | Hannah Margaret Brooks | Physician Assistant | 6565 France Ave S Ste 375, Edina, MN 55435-2141 | 2019-01-09 |
| 1598267676 | Tucker Boone Johnson | Physician Assistant | 6525 France Ave S Ste 200, Edina, MN 55435-2176 | 2018-03-05 |
| 1134637986 | Kristy Jordan Lichtenberg | Physician Assistant | 6565 France Ave S Ste 375, Edina, MN 55435-2141 | 2018-01-15 |
| 1902288905 | Katie Grausam | Physician Assistant | 6401 France Ave S, Edina, MN 55435-2104 | 2015-06-25 |
| 1104208768 | Kaylee Lynn Gibney | Physician Assistant | 6401 France Ave S, Edina, MN 55435-2104 | 2015-06-19 |
| Find all providers in EDINA | ||||
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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.