MS. ERIN MARIE WALLACE (NPI# 1649272378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649272378 |
| Entity Type | Individual |
| Full Name | MS. ERIN MARIE WALLACE |
| Other Name | MS. ERIN MARIE RUTKOSKI |
| Credential | PA-C |
| Practice Address |
651 Colliers Way Ste 201 Weirton WV 26062-5055 |
| Practice Telephone | 0437234700 |
| Practice Fax Number | 3047344719 |
| Mailing Telephone | 3047234700 |
| Mailing Fax Number | 3047234719 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA003119L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912337213 | Erin Elizabeth Wallace | Massage Therapist | 115 30th Ave, Apt B, Seattle, WA 98122-6229 | 2013-11-22 |
| 1396952263 | Erin Elizabeth Wallace | Pediatrics | 252 Matlock Rd Ste 330, Mansfield, TX 76063-4294 | 2007-05-17 |
| 1871713099 | Erin Renee Wallace | Speech-Language Pathologist | 16407 Azimuth Drive, Crosby, TX 77532 | 2007-04-27 |
| 1477063444 | Erin Melissa Wallace | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-04 |
| 1083966840 | Erin Wallace | Specialist | 1951 Caleb Ave, Syracuse, NY 13206-2560 | 2012-10-03 |
| 1730405598 | Erin Michelle Wallace | Psychiatry & Neurology | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5743 | 2010-04-19 |
| 1780842906 | Erin Wallace | Speech-Language Pathologist | 12110 Clayton Rd, Saint Louis, MO 63131-2516 | 2008-05-23 |
| Street Address |
651 COLLIERS WAY STE 201 |
| City | WEIRTON |
| State | WV |
| Zip Code | 26062-5055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578192290 | Braidy Nicole Tandon | Nurse Practitioner | 651 Colliers Way Ste 201, Weirton, WV 26062-5055 | 2020-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357935 | Hancock County School District | Speech-Language Pathologist | 3248 Pennsylvania Avenue, Weirton, WV 26062 | 2020-08-17 |
| 1982105441 | Maria Baldwin | Nurse Practitioner | 131 American Way, Weirten, WV 26062 | 2018-02-21 |
| 1194236604 | Rachel Lahita | Occupational Therapy Assistant | 3205 Rear Orchard St, Weirton, WV 26062 | 2017-10-24 |
| 1912424623 | Soleo Health Inc | Pharmacy | 204 Three Springs Dr Ste B, Weirton, WV 26062 | 2017-08-23 |
| 1255853313 | Kelli Elise Brooks | Dentist | 389 American Way, Weirton, WV 26062 | 2017-07-11 |
| 1750745030 | Jessica Bee | Pharmacist | 3901 Brightway, Weirton, WV 26062 | 2016-04-12 |
| 1396155487 | Jay Wyn LLC | Assisted Living Facility | 608 North 10th Street, Weirton, WV 26062 | 2014-04-29 |
| 1689084790 | Jay Wyn L.l.c | Assisted Living Facility | 610 North 10th Street, Weirton, WV 26062 | 2014-04-29 |
| 1750706503 | Patrick T Long Jr. | Massage Therapist | 3709 Collins Way, Weirton, WV 26062 | 2014-03-03 |
| 1689928921 | Austin Gregory White | Optometrist | 400 Three Springs Drive, Weirton, WV 26062 | 2012-11-08 |
| Find all providers in zip 26062 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639577117 | Jessica L Policastro | Physician Assistant | 3045 Pennsylvania Ave, Weirton, WV 26062-3770 | 2014-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386270908 | Bonnie Lynn Blackburn | Physician Assistant | 10 Amalia Dr Ste C5, Buckhannon, WV 26201-2270 | 2020-03-15 |
| 1922638824 | Sara B Johnson | Physician Assistant | 1000 Mon Health Medical Park Dr Ste 1100, Morgantown, WV 26505-1143 | 2020-01-19 |
| 1659835072 | Kristen Nicole Williams | Physician Assistant | 26 Portsmouth Ct N, Falling Waters, WV 25419-1430 | 2019-01-30 |
| 1629588876 | Robert Theodore Hartman | Physician Assistant | 620 National Rd Ste 300, Wheeling, WV 26003-6560 | 2017-10-02 |
| 1366967986 | Terri Leanne Belcher | Physician Assistant | 395 Emily Dr, Clarksburg, WV 26301-5505 | 2017-08-04 |
| 1760937056 | Ryan Aston | Physician Assistant | 58 16th St Fl 4, Wheeling, WV 26003-3660 | 2016-08-17 |
| 1821470113 | Lesley E. Weiss | Physician Assistant | 3200 Maccorkle Seave, Charleston, WV 25304-1227 | 2015-06-23 |
| 1891197323 | Rachelle Lyle Stewart | Physician Assistant | 1500 Terrace St Ste 105, Hinton, WV 25951-9768 | 2014-09-16 |
| 1285043224 | Sarah Gutman Brammer | Physician Assistant | 30 Medical Park Ste 211, Wheeling, WV 26003-6391 | 2014-08-04 |
| 1841603529 | Timothy Douglas | Physician Assistant | 4202 Mccorkle Ave Sw Ste 200, South Charleston, WV 25309-1513 | 2014-06-10 |
| 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.