MS. MICHELLE WALLACE (NPI# 1699804641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699804641 |
| Entity Type | Individual |
| Full Name | MS. MICHELLE WALLACE |
| Credential | NP |
| Practice Address |
3075 Governors Place Blvd Suite 210 Kettering OH 45409-1323 |
| Practice Telephone | 9372935200 |
| Mailing Telephone | 9372935200 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
NP-07879 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770051252 | Michelle Wallace | Technician | 1515 Sumac Rd, Fort Gibson, OK 74434-7512 | 2018-11-02 |
| 1437524196 | Michelle Wallace | Physical Therapist | 473 Auxier Dr, Cincinnati, OH 45244-2364 | 2015-12-07 |
| 1497091805 | Michelle Lynn Wallace | Specialist | 508 Blair Blvd, Eugene, OR 97402-4630 | 2012-12-13 |
| 1477808947 | Michelle Wallace | Physical Medicine & Rehabilitation | 75 Norman Pl, Tenafly, NJ 07670-2537 | 2012-07-19 |
| 1598884272 | Michelle Marie Wallace I | Registered Nurse | 17887 State Route 58, Wellington, OH 44090-9464 | 2007-03-27 |
| 1336796374 | Michelle Wallace | Counselor | 369 Ne Revere Ave Ste 101, Bend, OR 97701-4082 | 2019-08-23 |
| 1316471790 | Michelle Dianne Wallace | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2017-04-12 |
| 1972044519 | Michelle D Wallace | Durable Medical Equipment & Medical Supplies | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2017-03-15 |
| 1275938185 | Michelle Mayer Wallace | Pharmacist | 2413 Highway 431 North, Anniston, AL 36206 | 2014-11-04 |
| 1912249822 | Michelle M Wallace | Physical Therapist | 2300 Trenton Rd, Levittown, PA 19056-1423 | 2013-03-19 |
| Street Address |
3075 GOVERNORS PLACE BLVD SUITE 210 |
| City | KETTERING |
| State | OH |
| Zip Code | 45409-1323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467438580 | Mubin Isaac Syed | Radiology | 3075 Governors Place Blvd, Kettering, OH 45409-1323 | 2005-12-20 |
| 1669458261 | Kamal Nanubhai Morar | Radiology | 3075 Governors Place Blvd, Suite 120, Kettering, OH 45409-1323 | 2005-12-16 |
| 1316923915 | Dayton Interventional Radiology LLC | Podiatrist | 3075 Governors Place Blvd, Kettering, OH 45409-1323 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487276457 | Matthew R Schaeffer | Surgery | 128 E Apple St., Wche 7th Floor, Dayton, OH 45409 | 2020-05-13 |
| 1699237545 | Elizabeth Joan Hudson | Student in an Organized Health Care Education/Training Program | 1 Wyoming Street Miami Valley Hospital Medical Educatio, Dayton, OH 45409 | 2019-04-01 |
| 1760941066 | Courtney Lyn Johnson | Surgery | 128 East Apple Street, Wche 7th Floor, Dayton, OH 45409 | 2019-03-16 |
| 1477057529 | Adam Joseph Langer | Student in an Organized Health Care Education/Training Program | 128 E. Apple St Suite 3800, Wright State University Dept of Ob/gyn, Dayton, OH 45409 | 2018-03-22 |
| 1659870939 | Timothy Wall | Student in an Organized Health Care Education/Training Program | 128 East Apple St., 2nd Floor, Dayton, OH 45409 | 2018-02-01 |
| 1124551411 | Adam Schmerge Deardorff | Student in an Organized Health Care Education/Training Program | 30 E Apple St Ste 6257, Dayton, OH 45409 | 2017-04-04 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1689054223 | Jessica Ezinne Ugwu | Family Medicine | 30 E Apple St., Suite Nw 3300, Dayton, OH 45409 | 2015-06-08 |
| 1679983084 | Jude Anneryan Cohen | Registered Nurse | 1200 W. Dorothy Lane, Southdale Elementary School, Kettering, OH 45409 | 2014-05-07 |
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| Find all providers in zip 45409 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689699738 | Deborah Magnotta | Nurse Practitioner | 2221 Acorn Dr, Kettering, OH 45419-2745 | 2006-07-12 |
| 1740768340 | Brandie Lyn Mcguire | Nurse Practitioner | 3700 Southern Blvd Ste 401, Kettering, OH 45429-1226 | 2018-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384790 | Kimberly Chmielewski | Nurse Practitioner | 3422 Cross Creek Cir, Wooster, OH 44691-1861 | 2020-10-21 |
| 1649877077 | Lee Danielle Watts | Nurse Practitioner | 2152 E State Route 29, Urbana, OH 43078-9779 | 2020-10-08 |
| 1003425281 | Jessica Shattuck | Nurse Practitioner | 108 Slippery Rock Ln, Berea, OH 44017-3155 | 2020-07-23 |
| 1205460060 | Katherine Niles | Nurse Practitioner | 7884 Oak Valley Rd, Reynoldsburg, OH 43068-1577 | 2020-03-02 |
| 1447803267 | Amy Kathleen Mock | Nurse Practitioner | 575 Westar Xing Ste 102, Westerville, OH 43082-7815 | 2019-07-21 |
| 1659933729 | Ashley Marie Brown | Nurse Practitioner | 2055 Crocker Rd Ste 206, Westlake, OH 44145-2197 | 2019-06-28 |
| 1144881772 | Erin Burris | Nurse Practitioner | 201 5th St Ne Ste 15, Barberton, OH 44203-3017 | 2019-06-25 |
| 1326604299 | Tiffany Messerall | Nurse Practitioner | 1577 Guilford Rd, Columbus, OH 43221-3850 | 2019-05-15 |
| 1093298689 | Jennifer Emrick | Nurse Practitioner | 3909 Orange Pl Ste 4400, Beachwood, OH 44122-4482 | 2018-09-11 |
| 1730661703 | Lisa Taormina-dingman | Nurse Practitioner | 7067 Tiffany Blvd Ste 220, Poland, OH 44514-1981 | 2018-09-05 |
| 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.