PATRICIA G WALLACE (NPI# 1356368849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356368849 |
| Entity Type | Individual |
| Full Name | PATRICIA G WALLACE |
| Credential | CNS |
| Practice Address |
4847 E Virginia St Ste D Evansville IN 47715-2611 |
| Practice Telephone | 8124791242 |
| Practice Fax Number | 8124791330 |
| Mailing Telephone | (812) 479-1242 |
| Mailing Fax Number | 8124791330 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364S00000X | Clinical Nurse Specialist | 70000099A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
70000099B | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000492046 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7200 E Indiana St, Evansville, IN 477152753 | 8124767200 | 8124714514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434091 | Patricia J Wallace | Hearing Instrument Specialist | 1 Chesterfield Mall, Chesterfield, MO 63017-4807 | 2013-09-20 |
| 1043336704 | Patricia Irene Wallace | Counselor | 104 N 4th St, Hugo, OK 74743-4003 | 2007-03-22 |
| 1730683301 | Patricia Sue Wallace | Nurse Practitioner | 106 Market Place Cir, Georgetown, KY 40324-7400 | 2018-03-20 |
| 1548762958 | Patricia E. Wallace | Counselor | 3365 W Craig Rd Ste 25, North Las Vegas, NV 89032-5127 | 2018-03-01 |
| 1538606744 | Patricia Wallace | Occupational Therapist | 1755 Wittington Pl Ste 175, Dallas, TX 75234-1905 | 2017-01-25 |
| 1215398722 | Patricia Wallace | Marriage & Family Therapist | 901 N Pacific Coast Hwy, Suite 200a, Redondo Beach, CA 90277-2162 | 2016-03-10 |
| 1447553300 | Patricia A Wallace | Counselor | 450 Rosewood Ave, Suite215, Camarillo, CA 93010-5914 | 2010-12-15 |
| 1164750741 | Patricia Wallace | Occupational Therapist | 1818 W Worley St, Columbia, MO 65203-1038 | 2009-11-19 |
| 1174771281 | Patricia M Wallace | Acupuncturist | 217 1st St, Neptune Beach, FL 32266-6145 | 2008-09-03 |
| 1033393780 | Patricia Bonner Wallace | Counselor | 823 Evans St, Greenville, NC 27834-3267 | 2007-12-18 |
| Street Address |
4847 E VIRGINIA ST STE D |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47715-2611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730114877 | Jennifer E Murphy | Social Worker | 4847 E Virginia St Ste D, Evansville, IN 47715-2611 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1609339910 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1201 Cross Pointe Place, Evansville, IN 47715 | 2019-04-12 |
| 1497229223 | Hubert Family Dentistry LLP | Dentist | 6225 E Columbia St., Evansville, IN 47715 | 2019-01-15 |
| 1083110373 | Fyi Healthcare, LLC | Registered Nurse | 12000 Highway 41 North, Evansville, IN 47715 | 2018-04-04 |
| 1962862755 | New Journeys Counseling Services, LLC | Community/Behavioral Health | 4929 River Wind Pointe Drive, Evansville, IN 47715 | 2016-03-07 |
| 1558702456 | Jennifer Hoelter | Pharmacist | 5000 E Virginia St, Walgreens District Office, Evansville, IN 47715 | 2013-07-09 |
| 1952649402 | Courtney Ingold | Music Therapist | 621 E Cullen Ave, Suite 118, Evansville, IN 47715 | 2013-01-17 |
| 1922378041 | Sherry A. Fisher | Counselor | 4929 Riverwind Pointe Dr Ste 102, Evansville, IN 47715 | 2012-01-05 |
| 1710275912 | Tonja Leana Winekauf | Nurse Practitioner | 6211 E Waterford Blvd, Evansville Health Care Center, Evansville, IN 47715 | 2011-07-21 |
| 1003083437 | Allcare Dental & Dentures of In PC | Dentist | 1031 N. Green River Rd., Suite 104, Evansville, IN 47715 | 2008-05-14 |
| Find all providers in zip 47715 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851393094 | Cheryl F Thomas | Clinical Nurse Specialist | 728 N. Cross Pointe Blvd, Suite 102, Evansville, IN 47715 | 2005-06-01 |
| 1265881510 | Peace of Mind Counseling, LLC | Clinical Nurse Specialist | 728 N Cross Pointe Blvd, Suite 102, Evansville, IN 47715-9163 | 2016-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053650887 | Gerald Lewis Inc. | Clinical Nurse Specialist | 1150 Eastport Centre Dr, Suite D, Valparaiso, IN 46383-8427 | 2013-02-14 |
| 1437497864 | Abidemi Mary Ajuwon | Clinical Nurse Specialist | 3420 Cinnabar St, West Lafayette, IN 47906-7208 | 2013-01-18 |
| 1952603664 | Tara Elizabeth Gavardinas | Clinical Nurse Specialist | The Indiana Clinic, 340 W. 10th Street, Fs 5100, Indianapolis, IN 46202 | 2010-12-01 |
| 1407014327 | Regina Dawn Haight | Clinical Nurse Specialist | 1701 N Capitol Ave, C-3, Indianapolis, IN 46202-1203 | 2008-05-28 |
| 1073780102 | Deborah Lynn May | Clinical Nurse Specialist | 10748 Weston Dr, Carmel, IN 46032-9319 | 2008-05-08 |
| 1245403419 | Carol Agnes Essenmacher | Clinical Nurse Specialist | 8075 N Shadeland Ave Ste 350, Indianapolis, IN 46250-2693 | 2008-04-09 |
| 1508041716 | Elisabeth K Degenhardt | Clinical Nurse Specialist | 5230 E Stop 11 Rd Ste 300, Indianapolis, IN 46237-6401 | 2008-01-07 |
| 1306999131 | Kathleen R Lynch Lewis | Clinical Nurse Specialist | 281 Bielby Rd, Lawrenceburg, IN 47025-1055 | 2007-01-18 |
| 1831207000 | Frances Lucille Miller | Clinical Nurse Specialist | 145 Green Meadows Drive, Greenfield, IN 46140-4001 | 2006-08-28 |
| 1558308841 | Jennifer G Sims | Clinical Nurse Specialist | 1481 W 10th St # C-5085, Richard L Roudebush Va Medical Center, Indianapolis, IN 46202-2803 | 2006-06-02 |
| Find all providers with the same taxonomy | ||||
| City | EVANSVILLE |
| Zip Code | 47715 |
Please comment or provide details below to improve the information on PATRICIA G 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.