MR. EMERSON AKALEE WALLACE (NPI# 1336251560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336251560 |
| Entity Type | Individual |
| Full Name | MR. EMERSON AKALEE WALLACE |
| Credential | CFNP |
| Practice Address |
1154 Cross Creek Dr Saltillo MS 38866-5777 |
| Mailing Address |
118 Cr1810 Saltillo MS 38866 |
| Practice Telephone | 6628408010 |
| Practice Fax Number | 6628402656 |
| Mailing Telephone | 6628446596 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R759298 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0117978 | 05 |
| Street Address |
1154 CROSS CREEK DR |
| City | SALTILLO |
| State | MS |
| Zip Code | 38866-5777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063472157 | Michael Timothy Zanone | General Practice | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2006-03-24 |
| 1154844033 | Vanessa Jill Simmons | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2017-07-21 |
| 1306191705 | Sharon Kay Harmon | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2012-07-21 |
| 1083920987 | Katrina Watkins Frields | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2010-08-30 |
| 1518111723 | Sara Tate | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2008-11-14 |
| 1689786261 | Family + Urgent Care Clinic, Pa | Family Medicine | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2006-08-31 |
| 1235249376 | David Walden Bell | Family Medicine | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578019154 | North Mississippi Medical Center Inc. | Clinic/Center | 108 Desert Cove, Saltillo, MS 38866 | 2016-09-01 |
| 1386010718 | Dpti Elite Physical Therapy LLC | Physical Therapist | 2319 Hwy 145, Saltillo, MS 38866 | 2015-08-20 |
| 1891034435 | Nutrition Care LLC | Clinic/Center | 306 Cr 521, Saltillo, MS 38866 | 2013-02-01 |
| 1376705228 | Suzann Michelle Randle | Speech-Language Pathologist | 235 Cr 251, Saltillo, MS 38866 | 2008-07-01 |
| 1760670392 | Amanda Blount Ermis | Nurse Practitioner | 110 Big Harpe Trail, Saltillo, MS 38866 | 2007-10-09 |
| 1225157159 | Twincare Family Clinic | Clinic/Center | 2686 Hwy 145 S, Suite B, Saltillo, MS 38866 | 2007-03-29 |
| 1972656288 | Elite Physical Therapy, P.a. | Physical Therapist | 113 Town Creek Dr, Saltillo, MS 38866 | 2007-01-19 |
| 1245324417 | Martin Dental Clinic Pa | Dentist | 179 Mobile St, Saltillo, MS 38866 | 2006-10-03 |
| 1780786889 | North Mississippi Medical Clinics Inc | Family Medicine | 353 Mobile Street, Saltillo, MS 38866 | 2006-09-01 |
| 1437181088 | Julie C. Brock, O.d., Inc. | Optometrist | 107 Town Creek Drive, Suite A, Saltillo, MS 38866 | 2006-07-06 |
| Find all providers in zip 38866 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669917522 | Ashley Shaw | Nurse Practitioner | 48075 Highway 69, Saltillo, TN 38370-4514 | 2017-01-03 |
| 1942276845 | Cindy Oliver Holcomb | Nurse Practitioner | 2686 Highway 145, Saltillo, MS 38866-6941 | 2006-02-28 |
| 1154844033 | Vanessa Jill Simmons | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2017-07-21 |
| 1306191705 | Sharon Kay Harmon | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2012-07-21 |
| 1083920987 | Katrina Watkins Frields | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2010-08-30 |
| 1518111723 | Sara Tate | Nurse Practitioner | 1154 Cross Creek Dr, Saltillo, MS 38866-5777 | 2008-11-14 |
| 1053387969 | Wendy Oliver Howell | Nurse Practitioner | 2686 Highway 145, Suite B, Saltillo, MS 38866-6941 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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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.