SHANNON WALLACE (NPI# 1750757340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750757340 |
Entity Type | Individual |
Full Name | SHANNON WALLACE |
Credential | HOME HEATH AIDE |
Practice Address |
636 Candyce Ave Lakeland FL 33815-1202 |
Mailing Address |
636 Candyce Ave Same Lakeland FL 33815-1202 |
Practice Telephone | 8636144071 |
Mailing Telephone | 8636144071 |
Enumeration Date | 2015-08-18 |
Last Update Date | 2015-08-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 374U00000X | Home Health Aide | Nursing Service Related Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588142574 | Shannon Wallace | Specialist | 8777 254th St, Bellerose, NY 11426-2329 | 2018-08-01 |
1891223293 | Shannon May Wallace | Nurse Practitioner | 700 Childrens Dr Fl Hall1, Columbus, OH 43205-2664 | 2017-05-30 |
1538609847 | Shannon Wallace | Behavior Technician | 841 Hughes Ln, Highlands Ranch, CO 80126-4746 | 2017-03-06 |
1205102092 | Shannon Leigh Wallace | Obstetrics & Gynecology | Cleveland Clinic 9500 Euclid Avenue, Cleveland, OH 44195-1705 | 2012-03-27 |
1730328840 | Shannon D Wallace | Behavioral Analyst | 3954 Murphy Canyon Rd, Suite D105, San Diego, CA 92123-4418 | 2009-02-12 |
1437707452 | Shannon Wallace | Physical Therapy Assistant | 3108 Circle Dr, White Pine, TN 37890-3306 | 2019-09-03 |
1598103111 | Shannon R Wallace | Physician Assistant | 5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 | 2013-06-05 |
1326290982 | Shannon Mcnally Wallace | Social Worker | 3010 Falstaff Rd, Raleigh, NC 27610-1813 | 2008-10-15 |
1851481584 | Shannon L Wallace | Nurse Practitioner | 1001 W 10th St, Er/uvc, Indianapolis, IN 46202-2859 | 2006-10-13 |
Street Address |
636 CANDYCE AVE |
City | LAKELAND |
State | FL |
Zip Code | 33815-1202 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174162093 | Deborah Beall Boynton | Counselor | 219 Hillcrest St, Lakeland, FL 33815 | 2019-12-23 |
1992247373 | Lizvel Rosario | Counselor | 220 Lake Wire Dr., Lakeland, FL 33815 | 2016-11-16 |
1235554783 | Florida Baptist Children's Homes | Community Based Residential Treatment Facility, Mental Illness | 1015 Sikes Blvd., Lakeland, FL 33815 | 2014-02-20 |
1902229255 | Christina Miller | Nurse Practitioner | 6850 New Tampa Hwy Ste 600, Lakeland, FL 33815 | 2014-01-22 |
1902111099 | Jeanene Nicole Robinson-kyles | Psychologist | 505 Martin L. King Jr. Ave, Suite 1, Lakeland, FL 33815 | 2010-08-12 |
1235287095 | Wendell Owen Blake | Family Medicine | 505 Martin Luther King Ave, Suite 2, Lakeland, FL 33815 | 2007-01-08 |
1104983899 | Lake Wire Pharmacy Inc | Pharmacist | 505 Martin Luther King Jr Ave, Suite 3, Lakeland, FL 33815 | 2007-01-02 |
1427038637 | Rotech Oxygen and Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 5315 Great Oak Drive, Lakeland, FL 33815 | 2006-01-23 |
1598205841 | Daphne Toussaint | Dentist | 607 S Missouri Ave, Lakeland, FL 33815 | 2017-03-06 |
1083936058 | Blake and Franklin Md Pa | General Practice | 505 Martin Luther King Jr Ave, Ste 2, Lakeland, FL 33815 | 2010-02-18 |
Find all providers in zip 33815 |
Taxonomy Code | 374U00000X |
Grouping | Nursing Service Related Providers |
Classification | Home Health Aide |
A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932719242 | Jimia Watkins | Home Health Aide | 2410 Lakeview St, Lakeland, FL 33801 | 2020-08-03 |
1881215663 | Demetria L Mcgee | Home Health Aide | 1820 Salem Rd, Lakeland, FL 33803-2550 | 2020-05-03 |
1619513397 | Karen Shepherd Green | Home Health Aide | 2946 N Martha Ave, Lakeland, FL 33805-2240 | 2019-11-18 |
1912549924 | Ray Carla Pennick | Home Health Aide | 4278 Whistlewood Cir, Lakeland, FL 33811-3052 | 2019-10-10 |
1154814440 | Theressa W Hadley | Home Health Aide | 1422 Kettles Ave, Lakeland, FL 33805-3664 | 2018-06-11 |
1396252540 | Ariel Brown | Home Health Aide | 303 N Brunnell Pkwy Apt 51, Lakeland, FL 33815-1245 | 2018-01-09 |
1902261415 | Seanquanee Denazia Laster | Home Health Aide | 1603 Goodyear Ave, Lakeland, FL 33801-7030 | 2015-12-28 |
1043699051 | Ilene Shumaker Griffin | Home Health Aide | 2930 Oak Tree Ln, Lakeland, FL 33810 | 2015-05-22 |
1437769239 | Shannen J Lasane | Home Health Aide | 4006 Golf Village Loop Apt 2, Lakeland, FL 33809-4056 | 2020-08-06 |
1336661883 | Kimberly Draine | Home Health Aide | 1112 W 12th St, Lakeland, FL 33805-3465 | 2017-07-15 |
Find all providers in LAKELAND |
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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.