SUSAN ELIZABETH WALLACE (NPI# 1376842732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376842732 |
Entity Type | Individual |
Full Name | SUSAN ELIZABETH WALLACE |
Credential | R,D., L.D. |
Practice Address |
102 Carran Dr Lakeside Park KY 41017-2233 |
Practice Telephone | 8593312939 |
Mailing Telephone | 8593312939 |
Enumeration Date | 2011-03-23 |
Last Update Date | 2011-03-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 133V00000X | Dietitian, Registered | KY-1998 | KY | Dietary & Nutritional Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477910792 | Susan Anne Wallace | Licensed Practical Nurse | 44 Beechwood Dr, Manorville, NY 11949-2947 | 2016-01-16 |
1598904427 | Susan Leigh Wallace | Specialist | 103 Windwood Rd, North Syracuse, NY 13212-1956 | 2009-02-17 |
1366646457 | Susan Taylor Wallace | Speech-Language Pathologist | 3409 Connection Dr, Fayetteville, NC 28311-0151 | 2007-06-12 |
1952426025 | Susan Wallace | Acupuncturist | 1009 Solano Ave, # A, Albany, CA 94706-1617 | 2007-03-20 |
1447375662 | Susan D. Wallace | Counselor | 166 Pawtucket Avenue, Pawtucket, RI 02860-3811 | 2007-03-20 |
1639554769 | Susan Wallace | Physical Therapist | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2015-07-30 |
1740537687 | Susan R Wallace | Nurse Practitioner | 100 Methodist Blvd, Hattiesburg, MS 39402-1295 | 2012-08-09 |
1710247812 | Susan Victoria Wallace | Marriage & Family Therapist | 9685 Hayes St, Riverside, CA 92503-3660 | 2012-05-22 |
1427203462 | Susan Marie Wallace | Occupational Therapist | 355 Oak Grove Rd, Spartanburg, SC 29301-2537 | 2008-11-18 |
1194985887 | Susan Jean Wallace | Registered Nurse | E Hwy 18, Pine Ridge, SD 57770-1201 | 2008-06-16 |
Street Address |
102 CARRAN DR |
City | LAKESIDE PARK |
State | KY |
Zip Code | 41017-2233 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
Find all providers in zip 41017 |
Taxonomy Code | 133V00000X |
Grouping | Dietary & Nutritional Service Providers |
Classification | Dietitian, Registered |
A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851908727 | Laura Elizabeth Dean | Dietitian, Registered | 411 E Chestnut St Ste 544, Louisville, KY 40202-1713 | 2020-09-25 |
1629684907 | Jaclyn Vaughn Moore | Dietitian, Registered | 234 E Gray St Ste 164, Louisville, KY 40202-1903 | 2020-09-22 |
1790391118 | Elizabeth Marie Riddle | Dietitian, Registered | 4955 Norton Healthcare Blvd Ste 102, Louisville, KY 40241-2832 | 2020-09-21 |
1386259471 | Ethan Mattingly | Dietitian, Registered | 175 Thad Redman Rd, Payneville, KY 40157-7524 | 2020-09-15 |
1801401294 | Elizabeth Bell | Dietitian, Registered | 241 Franck Ave, Louisville, KY 40206-2544 | 2020-09-11 |
1033722855 | Britanii P Mcwhorter | Dietitian, Registered | 770 Roberts Rd, Campbellsville, KY 42718-6740 | 2020-08-31 |
1245843291 | Lindsay Gabbard | Dietitian, Registered | 115 Eddie Dr, Mount Vernon, KY 40456-7574 | 2020-08-28 |
1134732183 | Tracey True | Dietitian, Registered | 880 Sandstone Rdg, Cold Spring, KY 41076-7119 | 2020-08-28 |
1194342519 | Joella Crowder | Dietitian, Registered | 15 Shannon Ln, Somerset, KY 42503-4958 | 2020-07-01 |
1982221305 | Rebecca Jean Lyons | Dietitian, Registered | 741 Frozen Crk, Raccoon, KY 41557-8506 | 2020-07-01 |
Find all providers with the same taxonomy |
City | LAKESIDE PARK |
Zip Code | 41017 |
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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.