MS. PAULA M. WALLACE (NPI# 1689698490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689698490 |
| Entity Type | Individual |
| Full Name | MS. PAULA M. WALLACE |
| Credential | P.A. |
| Practice Address |
212 Walnut St Ste 110 Monroe LA 71201-6707 |
| Mailing Address |
312 Grammont St Ste 404 Monroe LA 71201-7403 |
| Practice Telephone | 3183231809 |
| Practice Fax Number | 3183232668 |
| Mailing Telephone | 3183231809 |
| Mailing Fax Number | 3183232668 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
P.A.A10590.RX | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1429112 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881248631 | Paula Renee Wallace | Social Worker | 511 8th St, Clarksville, TN 37040-3093 | 2019-07-30 |
| 1902078033 | Paula J Wallace | Counselor | 1250 15th St W, Suite 201, Billings, MT 59102-4155 | 2008-03-28 |
| Street Address |
212 WALNUT ST STE 110 |
| City | MONROE |
| State | LA |
| Zip Code | 71201-6707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649617259 | Cain Neurosurgery Clinic A Professional Medical Corporation | Neurological Surgery | 212 Walnut St, Suite 110, Monroe, LA 71201-6700 | 2013-05-23 |
| 1487985354 | North Louisiana Counseling Associates, LLC | Counselor | 212 Walnut St, Suite 210, Monroe, LA 71201-6700 | 2010-01-16 |
| 1992828123 | Ouachita Neurosurgery Center A Medical Corporation | Specialist | 212 Walnut St, Suite 110, Monroe, LA 71201-6700 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
| 1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
| 1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
| 1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
| 1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
| 1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
| 1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
| Find all providers in zip 71201 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922422278 | Frank Tanner | Physician Assistant | 146 Martin Luther King Jr Blvd#302, Monroe, GA 30655 | 2014-02-06 |
| 1235195835 | Angela M Clark | Physician Assistant | 2009 5th St, Monroe, WI 53566-1546 | 2006-04-22 |
| 1851768139 | Joseph Roger Fandal | Physician Assistant | 1501 Louisville Ave, Monroe, LA 71201-6025 | 2015-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423151 | Osler Surgical Services LLC | Physician Assistant | 929 Tezcucco Ct, Covington, LA 70433-8157 | 2020-10-02 |
| 1841841855 | Kasie Danielle Nelson | Physician Assistant | 8585 Picardy Ave Ste 514, Baton Rouge, LA 70809-3748 | 2019-09-23 |
| 1013575018 | Louisiana Surgical Assist, L.L.C. | Physician Assistant | 1374 Knollwood Dr, Baton Rouge, LA 70808-8647 | 2019-06-04 |
| 1285290098 | Nicole Michelle Toups | Physician Assistant | 2551 Greenwood Rd Ste 311, Shreveport, LA 71103-3981 | 2019-05-16 |
| 1437712114 | Karley Marie Boagni | Physician Assistant | 3434 Prytania St Ste 410, New Orleans, LA 70115-3574 | 2019-04-17 |
| 1144793175 | Picardy Surgical Assist II, L.L.C. | Physician Assistant | 7425 Bocage Blvd, Baton Rouge, LA 70809-1141 | 2019-01-02 |
| 1952874984 | Perkins Surgical Assist II, L.L.C. | Physician Assistant | 18611 Saint Andrews Ct W, Prairieville, LA 70769-3251 | 2019-01-02 |
| 1578033825 | Picardy Surgical Assist, L.L.C. | Physician Assistant | 7301 Hennessy Blvd Ste 300, Baton Rouge, LA 70808-4794 | 2018-11-29 |
| 1609362177 | Harley Ann Augustine | Physician Assistant | 3001 Division St, Metairie, LA 70002-5854 | 2018-07-07 |
| 1750880134 | Robert Gomann Genovese II | Physician Assistant | 1233 Wayne Gilmore Cir Ste 250a, Opelousas, LA 70570-6405 | 2018-02-12 |
| 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.