MRS. STEPHANIE WALLACE


Address: 1625 N Campbell Ave, Tucson, AZ 85719-4330
Phone: 5206940111

MRS. STEPHANIE WALLACE (NPI# 1477924082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477924082
Entity Type Individual
Full Name MRS. STEPHANIE WALLACE
Other Name STEPHANIE RUKASIN
Credential PA-C
Practice Address 1625 N Campbell Ave
Tucson
AZ 85719-4330
Mailing Address 3870 W Wild Horse Pl
Tucson
AZ 85741-1906
Practice Telephone 5206940111
Mailing Telephone 5203079417
Enumeration Date 2015-10-08
Last Update Date 2020-01-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 6214 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Providers STEPHANIE WALLACE

NPI Name Taxonomy Address Enumeration
1225509524 Stephanie Wallace Speech-Language Pathologist 1014 Glen Crossing Rd, Glen Carbon, IL 62034-8517 2018-12-11
1679755003 Stephanie R Wallace Occupational Therapy Assistant 5626 Lasater Dr Nw Apt 5, Canton, OH 44718-1923 2007-11-27
1841289022 Stephanie R Wallace Pediatrics 2405 Research Parkway, Colorado Springs, CO 80918 2005-10-19
1023619061 Stephanie Lynn Wallace Pharmacist 254 Cassidy Blvd, Pikeville, KY 41501-1426 2020-11-05
1750988127 Stephanie Wallace Marriage & Family Therapist 730 Medical Center Ct, Chula Vista, CA 91911-6618 2020-10-07
1407483878 Stephanie L Wallace Marriage & Family Therapist 1212 Hancock St Ste 205, Quincy, MA 02169-4371 2020-03-25
1427534718 Stephanie E Wallace Nurse Anesthetist, Certified Registered 200 Mercy Circle, Camp Pendleton, CA 92055 2018-07-19
1740791714 Stephanie Wallace Genetic Counselor, MS 6431 Fannin Street, Msb 6.100, Houston, TX 77030 2017-10-18
1477943223 Stephanie Wallace Pharmacist 815 Cheyenne Meadows Rd, Colorado Springs, CO 80906-4929 2015-02-02
1033533617 Stephanie Wallace Counselor 2001 W Blue Heron Blvd, Riviera Beach, FL 33404-5003 2014-02-18

Office Location

Street Address 1625 N CAMPBELL AVE
City TUCSON
State AZ
Zip Code 85719-4330

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104816800 Suelyn D Hall-harper Urology 1625 N Campbell Ave, Tucson, AZ 85719-4330 2005-10-24
1396345955 Deanna Lee Merrill Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-10-31
1952900565 Kayla Mckenna Meyers Electrodiagnostic Medicine 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-10-23
1972110922 Joel S Silva Nurse Practitioner 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-09-24
1730792672 Garret Sewell Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-08-29
1144832304 Suzannah Gallaher Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-08-19
1497367502 Nichole Carrigan Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-08-19
1184236531 Jeremiah James Palicka Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-08-18
1841802378 Brittany Ann Rygg Registered Nurse 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-08-17
1891304192 Nadeem Hussain Internal Medicine 1625 N Campbell Ave, Tucson, AZ 85719-4330 2020-07-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649813635 Ishani Ravindra Deo Psychologist 1051 E Mabel St, Tucson, AZ 85719 2019-10-22
1235793100 Jacquelyn Christine Wagner Pediatrics 1625 N Campbell, Tucson, AZ 85719 2019-04-26
1831652189 Derek Allan Hatfield Emergency Medicine 1625 N Campbell Ave., Tucson, AZ 85719 2019-04-12
1053874305 Travis Patrick Martin Emergency Medicine 1625 N. Campbell Ave, Tucson, AZ 85719 2019-04-12
1245793504 Martin Cisneroz Emergency Medicine 1625 North Campbell Avenue, Tucson, AZ 85719 2019-04-12
1174086722 Sarah Joy Ring Emergency Medicine 1625 N. Campbell Ave., Tucson, AZ 85719 2019-04-10
1790245520 Akash M Doshi Student in an Organized Health Care Education/Training Program 3838 N Campbell Avenue, Bldg 2, Tuscon, AZ 85719 2019-03-20
1942773668 Jeffery Roy Small Massage Therapist 3607 N Vine, Tucson, AZ 85719 2019-01-04
1114434180 Elizabeth Irene Welch Behavioral Analyst 1430 E Fort Lowell Rd Ste 100, Tucson, AZ 85719 2017-12-29
1477076255 Medavail Pharmacy Inc. Pharmacy 1430 E Fort Lowell Rd Ste 120, Tucson, AZ 85719 2017-07-24
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457966640 Stephanie Alonso Physician Assistant 7725 N Sun Flair Dr, Tucson, AZ 85741-1582 2020-09-14
1902416084 Nooria Sufi Physician Assistant 3849 E Calle De Soto, Tucson, AZ 85716-5125 2020-08-04
1578189650 Emily Alaine Maru Physician Assistant 9641 E Waters Edge Pl, Tucson, AZ 85749-7901 2020-06-24
1144863481 Daniel E Valdez Physician Assistant 7360 S Frost Dr, Tucson, AZ 85747-5641 2019-10-18
1831663731 Chenin Poels Physician Assistant 1652 E Saint Ferdinand Pl, Tucson, AZ 85713-5185 2019-01-14
1750864310 Stephen Skiano Physician Assistant 3615 N Prince Village Pl Ste 121, Tucson, AZ 85719-2034 2018-09-10
1215415112 Chelsea Marie Baker Physician Assistant 2495 N Desert Links Dr Apt 11, Tucson, AZ 85715-3727 2018-08-02
1891209268 Samantha Martinez Physician Assistant 7089 N Thornydale Rd, Tucson, AZ 85741-2728 2017-11-21
1851819692 Clayton Harrison Andrews Physician Assistant 1501 N Campbell Ave Rm 4325, Tucson, AZ 85724-0001 2017-08-31
1831613579 Ashley Shaw Physician Assistant 5856 N Placita Esplendora, Tucson, AZ 85718 2017-08-02
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Competitor

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City TUCSON
Zip Code 85719

Improve Information

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Dataset Information

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.

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